MEDICARE: GEORGIA CARMALEA RODGERS

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	374J00000X	Doula	SMA-00128	MO

General Provider Information

NPI Number	:	1326986555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGIA CARMALEA RODGERS

Provider Business Mailing Address
First Line	:	3826 COUNTY ROAD 324
Second Line	:
City	:	JACKSON
State	:	MO
Zip	:	63755-7526
Country	:	US
Telephone Number	:	573-510-0486
Fax Number	:

Provider Business Practice Location Address
First Line	:	3826 COUNTY ROAD 324
Second Line	:
City	:	JACKSON
State	:	MO
Zip	:	63755-7526
Country	:	US
Telephone Number	:	573-510-0486
Fax Number	:

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

Provider Enumeration Date	:	03/21/2026
Last Update Date	:	03/21/2026

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Directions to “ GEORGIA CARMALEA RODGERS ” Practice Location

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