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NPI Code Detail

MEDICARE: JACQUELINE L ROGERS RD

MEDICARE:   JACQUELINE L ROGERS  RD
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
1133V00000XRegistered DietitianLDN0000001484TN

General Provider Information

NPI Number : 1831229236
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE L ROGERS RD
Provider Business Mailing Address
First Line : 721 GLENWOOD DR STE W550
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-1155
Country : US
Telephone Number : 423-698-8692
Fax Number : 423-624-7813
Provider Business Practice Location Address
First Line : 721 GLENWOOD DR STE W550
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-1155
Country : US
Telephone Number : 423-698-8692
Fax Number : 423-624-7813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 01/06/2026

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Directions to “ JACQUELINE L ROGERS RD” Practice Location

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