MEDICARE: ALLISON LEIGH 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	363LF0000X	Family Nurse Practitioner	2021028485	MO

General Provider Information

NPI Number	:	1902567985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON LEIGH RODGERS

Provider Business Mailing Address
First Line	:	11391 LINDA DR
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-7310
Country	:	US
Telephone Number	:	573-795-9906
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N MAIN ST
Second Line	:
City	:	MONROE CITY
State	:	MO
Zip	:	63456-1318
Country	:	US
Telephone Number	:	573-735-4541
Fax Number	:

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

Provider Enumeration Date	:	01/03/2022
Last Update Date	:	07/25/2022

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Directions to “ ALLISON LEIGH RODGERS ” Practice Location

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