Provider Demographics
NPI:1205652625
Name:RODGERS, MARY ANN (CMI)
Entity type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:CMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11450 N SETTLERS DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8033
Mailing Address - Country:US
Mailing Address - Phone:720-257-3617
Mailing Address - Fax:
Practice Address - Street 1:11450 N SETTLERS DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8033
Practice Address - Country:US
Practice Address - Phone:720-257-3617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103334171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter