Provider Demographics
NPI:1578846200
Name:ROGERS, DENNIS R (LPN)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:R
Last Name:ROGERS
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1874 CUTACROSS RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697-9554
Mailing Address - Country:US
Mailing Address - Phone:937-217-0702
Mailing Address - Fax:
Practice Address - Street 1:1874 CUTACROSS RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45697-9554
Practice Address - Country:US
Practice Address - Phone:937-217-0702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.141511-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse