Individual
LARA M RODEFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3188 BELLEVUE AVE, CINCINNATI, OH 45219-2369
(513) 558-5281
Mailing address
PO BOX 636256, CINCINNATI, OH 45263-6256
(513) 585-6200
(513) 245-3672
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0029470
OH
363LA2100X
Acute Care Nurse Practitioner
0029470
OH
363LA2100X
Acute Care Nurse Practitioner
71012422A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460071
—
OH
05
—
300055281
—
IN
Enumeration date
08/31/2021
Last updated
07/03/2024
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