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General NPI Number Information
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NPI Number | 1255400578
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Entity Type | Individual
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Provider Name | JUDITH ANN RODGERS RNC
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2250 WEHRLE DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7037
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Country | US
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Telephone | 716-276-2123
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Fax | 716-276-2129
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Provider Business Mailing Address
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Address Line | 7282 SHAWNEE RD APT 12
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City | N TONAWANDA
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State | NY
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Zip | 14120-1320
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Country | US
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Telephone | 716-694-5634
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 278310
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License Number State | NY
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