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General NPI Number Information
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NPI Number | 1306708300
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Entity Type | Individual
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Provider Name | MS. CHARLIE JEAN ROGERS
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Gender | Female
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Dates
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Enumeration Date | 11/27/2025
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 1111 W 17TH ST
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City | TULSA
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State | OK
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Zip | 74107-1886
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Country | US
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Telephone | 918-561-8324
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Fax |
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Provider Business Mailing Address
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Address Line | 6905 CHIGLEY RD
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City | WYNNEWOOD
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State | OK
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Zip | 73098-8963
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Country | US
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Telephone | 580-369-0437
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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