Provider Demographics
NPI:1003877978
Name:ROGERS, KAREN A (PA-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S. LINCOLN AVENUE
Mailing Address - Street 2:LEBANON VAMC
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7529
Mailing Address - Country:US
Mailing Address - Phone:717-272-4366
Mailing Address - Fax:717-228-6031
Practice Address - Street 1:1700 S LINCOLN AVE
Practice Address - Street 2:LEBANON VAMC
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7529
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:717-228-6031
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003562L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03246601OtherCAPITAL BLUE CROSS
PAP00652656OtherRAILROAD MEDICARE
P30850Medicare UPIN
PA161074KAGMedicare PIN
PAP00652656OtherRAILROAD MEDICARE
PA047573Medicare ID - Type Unspecified