Provider Demographics
NPI:1609008523
Name:ROGERS, CAROL ANN
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-4603
Mailing Address - Country:US
Mailing Address - Phone:207-892-7141
Mailing Address - Fax:207-892-6131
Practice Address - Street 1:495 RIVER RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4603
Practice Address - Country:US
Practice Address - Phone:207-892-7141
Practice Address - Fax:207-892-6131
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME200090000OtherMAINE CARE