Provider Demographics
NPI:1417317652
Name:ROGERSON, CATHERINE ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:ROGERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5707 LAUREL TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2432
Mailing Address - Country:US
Mailing Address - Phone:804-350-4352
Mailing Address - Fax:
Practice Address - Street 1:5707 LAUREL TRAIL RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2432
Practice Address - Country:US
Practice Address - Phone:804-350-4352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program