Healthcare Provider Details

I. General information

NPI: 1487157129
Provider Name (Legal Business Name): BETTINA ROGERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2018
Last Update Date: 03/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N LORRAINE ST STE 202
HUTCHINSON KS
67501-5600
US

IV. Provider business mailing address

1600 N LORRAINE ST STE 202
HUTCHINSON KS
67501-5600
US

V. Phone/Fax

Practice location:
  • Phone: 620-663-7595
  • Fax: 620-663-5263
Mailing address:
  • Phone: 620-663-7595
  • Fax: 620-663-5263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number101226
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: