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General NPI Number Information
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NPI Number | 1679338388
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Entity Type | Organization
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Legal Business Name | ANGELA ROGERS FAMILY PRACTICE
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 1134 HAGER ST
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City | SAINT MARYS
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State | OH
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Zip | 45885-2423
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Country | US
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Telephone | 937-538-1884
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 HAGER ST
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City | SAINT MARYS
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State | OH
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Zip | 45885-2423
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Country | US
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Telephone | 937-538-1884
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | MRS. ANGELA MARIE ROGERS
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Credential | APRN
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Telephone | 937-538-1884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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