Healthcare Provider Details

I. General information

NPI: 1912840299
Provider Name (Legal Business Name): CALI LYNN ROGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 HOSPITAL DR
OSAGE BEACH MO
65065-3050
US

IV. Provider business mailing address

621 JOSEPH CT
LEBANON MO
65536-8700
US

V. Phone/Fax

Practice location:
  • Phone: 417-718-2672
  • Fax:
Mailing address:
  • Phone: 417-718-2672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026015752
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: