Provider Demographics
NPI:1053073718
Name:ROGERS, CASEY KENNEDY (PA)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:KENNEDY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21018-0130
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-623-1227
Practice Address - Street 1:7601 OSLER DR
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7700
Practice Address - Country:US
Practice Address - Phone:877-346-2211
Practice Address - Fax:626-623-1227
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2022-09-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant