Provider Demographics
NPI:1922355098
Name:RODGERS, DANICE (CSFA)
Entity Type:Individual
Prefix:MRS
First Name:DANICE
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8091 TOWNSHIP LINE RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2494
Mailing Address - Country:US
Mailing Address - Phone:317-802-9900
Mailing Address - Fax:317-808-9911
Practice Address - Street 1:8091 TOWNSHIP LINE RD
Practice Address - Street 2:SUITE 109
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2494
Practice Address - Country:US
Practice Address - Phone:317-802-9900
Practice Address - Fax:317-808-9911
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN125250246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist