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General NPI Number Information
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NPI Number | 1417791393
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Entity Type | Individual
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Provider Name | MICHELLE ANNE ROGERS
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Gender | Female
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Dates
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Enumeration Date | 06/24/2024
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 3001 BROADMOOR BLVD NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-2100
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Country | US
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Telephone | 505-994-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 14 S 74TH ST
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City | KANSAS CITY
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State | KS
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Zip | 66111-2615
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Country | US
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Telephone | 913-209-5461
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 13-106964-041
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License Number State | KS
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