Provider Demographics
NPI:1508167875
Name:RODGERS, MELISSA RENEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:RENEE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22675 E AURORA PKWY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-6075
Mailing Address - Country:US
Mailing Address - Phone:303-693-0493
Mailing Address - Fax:303-693-0574
Practice Address - Street 1:22675 E AURORA PKWY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-6075
Practice Address - Country:US
Practice Address - Phone:303-693-0493
Practice Address - Fax:303-693-0574
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist