Healthcare Provider Details

I. General information

NPI: 1952685620
Provider Name (Legal Business Name): KATHY ROGIEN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 01/02/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TH MICHIGAN HEART 5325 ELLIOTT DRIVE 2ND FLOOR
YPSILANTI MI
48197-8633
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DRIVE SUITE J2000
ANN ARBOR MI
48105
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-8000
  • Fax: 734-712-8010
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704361398
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209010373
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: