Provider Demographics
NPI:1902188725
Name:ROGERS, VANESSA ANN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:ANN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 S US HIGHWAY 25E
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-8005
Mailing Address - Country:US
Mailing Address - Phone:606-545-7314
Mailing Address - Fax:606-545-5417
Practice Address - Street 1:1121 S US HIGHWAY 25E
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-8005
Practice Address - Country:US
Practice Address - Phone:606-545-7314
Practice Address - Fax:606-545-5417
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14346183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist