Healthcare Provider Details

I. General information

NPI: 1588608491
Provider Name (Legal Business Name): JENNIFER LYNN ROGERS AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 S MCINTIRE DR SUITE 350
BLOOMINGTON IN
47403-4221
US

IV. Provider business mailing address

2920 S MCINTIRE DR STE 350
BLOOMINGTON IN
47403-4215
US

V. Phone/Fax

Practice location:
  • Phone: 812-332-2226
  • Fax: 812-339-2934
Mailing address:
  • Phone: 812-332-2226
  • Fax: 812-339-2934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002164A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: