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NPI Code Detail

MEDICARE: MS. BONNIE SUE RODGERS CRNP

MEDICARE: MS. BONNIE SUE RODGERS CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerTP005113BPA

General Provider Information

NPI Number : 1023095981
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BONNIE SUE RODGERS CRNP
Provider Business Mailing Address
First Line : 1740 BORLAND RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15243-1524
Country : US
Telephone Number : 412-429-7210
Fax Number :
Provider Business Practice Location Address
First Line : 300 PENN LINCOLN DR
Second Line :
City : IMPERIAL
State : PA
Zip : 15126-9772
Country : US
Telephone Number : 724-773-3002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 01/26/2016

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