Provider Demographics
NPI:1790278182
Name:RODGERS, LUCINDA SUE
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:SUE
Last Name:RODGERS
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 1:340 LINCOLN ST SW APT D
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9366
Mailing Address - Country:US
Mailing Address - Phone:330-614-1031
Mailing Address - Fax:
Practice Address - Street 1:340 LINCOLN ST SW APT D
Practice Address - Street 2:
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9366
Practice Address - Country:US
Practice Address - Phone:330-614-1031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty