MEDICARE: KATHLEEN B. ROGERS APRN.CNP

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
1	363L00000X	Nurse Practitioner	APRN.CNP.01162	OH
2	363LA2200X	Adult Health Nurse Practitioner	01162	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093711988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN B. ROGERS APRN.CNP

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-0066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1145 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3117
Country	:	US
Telephone Number	:	614-293-0066
Fax Number	:	614-293-7264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	12/14/2020

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