Provider Demographics
NPI:1891204871
Name:ROGERS, ANN BROOK (ARNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:BROOK
Last Name:ROGERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:BROOK
Other - Last Name:THEODORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10170 NICHOLAS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2174
Mailing Address - Country:US
Mailing Address - Phone:402-391-3800
Mailing Address - Fax:402-934-1676
Practice Address - Street 1:902 S 6TH ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-6441
Practice Address - Country:US
Practice Address - Phone:712-325-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE72934163WE0003X
NE112528207RR0500X
IAA127580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily