Provider Demographics
NPI:1467794289
Name:ROGERS, VALERIE (RD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 NE TOPAZ DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-7032
Mailing Address - Country:US
Mailing Address - Phone:816-305-7060
Mailing Address - Fax:
Practice Address - Street 1:608 NE TOPAZ DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-7032
Practice Address - Country:US
Practice Address - Phone:816-305-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006005736133V00000X
KS1480133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered