Provider Demographics
NPI:1497239933
Name:ROGICH, VANESSA ROSE (DNP, APNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ROSE
Last Name:ROGICH
Suffix:
Gender:F
Credentials:DNP, APNP, FNP-C
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:ROSE
Other - Last Name:RUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:608-785-0940
Mailing Address - Fax:
Practice Address - Street 1:325 BUTTS AVE
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-1412
Practice Address - Country:US
Practice Address - Phone:608-392-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI241597163W00000X
WI14397363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F06230549OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD (AANPCB) CERTIFICATE