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General NPI Number Information
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NPI Number | 1710795240
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Entity Type | Individual
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Provider Name | TELENA L ROGERS
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 1017 W 7TH ST
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City | WRAY
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State | CO
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Zip | 80758-1420
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Country | US
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Telephone | 970-332-4811
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Fax |
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Provider Business Mailing Address
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Address Line | 43380 CR EE
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City | WRAY
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State | CO
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Zip | 80758
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Country | US
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Telephone | 719-343-3804
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F12240566
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License Number State | CO
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