Provider Demographics
NPI:1225205248
Name:ROGERS, DONNA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 GLENNA LITTLE TRL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1968
Mailing Address - Country:US
Mailing Address - Phone:631-423-7479
Mailing Address - Fax:
Practice Address - Street 1:75 GLENNA LITTLE TRL
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-1968
Practice Address - Country:US
Practice Address - Phone:631-423-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244149164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse