Provider Demographics
NPI:1396949434
Name:RODGERS, CLARE MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:MARIE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 DEFENSE HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2931
Mailing Address - Country:US
Mailing Address - Phone:410-451-9091
Mailing Address - Fax:410-451-9094
Practice Address - Street 1:2191 DEFENSE HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2931
Practice Address - Country:US
Practice Address - Phone:410-451-9091
Practice Address - Fax:410-451-9094
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR063809163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR063809OtherSTATE LICENSE