Provider Demographics
NPI:1427370170
Name:ROGERS, DAWN M (RN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:M
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 N JEFFERSON ST
Mailing Address - Street 2:UNIT E
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1296
Mailing Address - Country:US
Mailing Address - Phone:330-722-7684
Mailing Address - Fax:330-725-7649
Practice Address - Street 1:1045 N JEFFERSON ST
Practice Address - Street 2:UNIT E
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1296
Practice Address - Country:US
Practice Address - Phone:330-722-7684
Practice Address - Fax:330-725-7649
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.188177163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management