Provider Demographics
NPI:1770040909
Name:ROGERS, HANNAH EMILY (LVN)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:EMILY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 WALNUT ST STE B
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-3611
Mailing Address - Country:US
Mailing Address - Phone:530-527-5637
Mailing Address - Fax:
Practice Address - Street 1:1860 WALNUT ST STE B
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3611
Practice Address - Country:US
Practice Address - Phone:530-527-5637
Practice Address - Fax:530-527-0249
Is Sole Proprietor?:No
Enumeration Date:2019-02-24
Last Update Date:2019-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA687458164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse