Provider Demographics
NPI:1437850070
Name:ROLFS, LORRI ANN (CAREGIVER)
Entity type:Individual
Prefix:
First Name:LORRI
Middle Name:ANN
Last Name:ROLFS
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:COAL VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61240-9328
Mailing Address - Country:US
Mailing Address - Phone:309-716-9152
Mailing Address - Fax:
Practice Address - Street 1:410 W 15TH AVE
Practice Address - Street 2:
Practice Address - City:COAL VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61240-9328
Practice Address - Country:US
Practice Address - Phone:309-716-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider