MEDICARE: BELINDA C ROGERS RNC, WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	105371	MO

General Provider Information

NPI Number	:	1801934773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELINDA C ROGERS RNC, WHNP

Provider Business Mailing Address
First Line	:	625 WILLOW LN
Second Line	:
City	:	LEBANON
State	:	MO
Zip	:	65536-3578
Country	:	US
Telephone Number	:	417-588-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 BAGNELL DAM BLVD STE 209
Second Line	:
City	:	LAKE OZARK
State	:	MO
Zip	:	65049-9806
Country	:	US
Telephone Number	:	573-365-3244
Fax Number	:	573-365-3720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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