Provider Demographics
NPI:1003180001
Name:ROGERS, JULIA ANTONIA (CRT)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANTONIA
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2870 S MARYLAND PKWY.
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1548
Mailing Address - Country:US
Mailing Address - Phone:702-893-3333
Mailing Address - Fax:702-893-0960
Practice Address - Street 1:1470 E CALVADA BLVD.
Practice Address - Street 2:SUITE #100
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-3906
Practice Address - Country:US
Practice Address - Phone:775-751-1819
Practice Address - Fax:775-751-1823
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC2077227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV1702161Medicaid
NVNV1702161Medicaid
NVGC779AMedicare PIN
NVCCN297191Medicare PIN