Healthcare Provider Details

I. General information

NPI: 1144748195
Provider Name (Legal Business Name): CATHERINE MURPHY ROGERS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 HEARNE AVE STE 300
SHREVEPORT LA
71103-3918
US

IV. Provider business mailing address

161 ALBANY AVE
SHREVEPORT LA
71105-2101
US

V. Phone/Fax

Practice location:
  • Phone: 318-798-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: