Provider Demographics
NPI:1043702350
Name:ROGERS, KATRIEL MARIE (CPM)
Entity Type:Individual
Prefix:MRS
First Name:KATRIEL
Middle Name:MARIE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:TN
Mailing Address - Zip Code:37353-5484
Mailing Address - Country:US
Mailing Address - Phone:423-303-8159
Mailing Address - Fax:
Practice Address - Street 1:790 PINE HILL RD
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:TN
Practice Address - Zip Code:37353-5484
Practice Address - Country:US
Practice Address - Phone:423-303-8159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2019-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife