Provider Demographics
NPI:1740287416
Name:ROGERS, ANN JEANNETTE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:JEANNETTE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 N 139TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-4234
Mailing Address - Country:US
Mailing Address - Phone:913-721-3641
Mailing Address - Fax:913-721-3649
Practice Address - Street 1:619 SW CORPORATE VIEW
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1233
Practice Address - Country:US
Practice Address - Phone:785-232-1888
Practice Address - Fax:785-232-3354
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-25479-112367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100245830GMedicaid
1977OtherPREFERRED HEALTH SYSTEMS
36613027OtherBLUE CROSS BLUE SHIELD KC
KS145354OtherBLUE CROSS BLUE SHIELD KS
5766480OtherFIRST HEALTH
KS9159784401Medicaid
10001878200OtherCOMMUNITY HEALTH PLAN
KSP00346153OtherRAILROAD MEDICARE
KSR31875Medicare UPIN
36613027OtherBLUE CROSS BLUE SHIELD KC
KSP00346153OtherRAILROAD MEDICARE
KS015342Medicare ID - Type UnspecifiedEMPORIA ANES ASSOC,. P.A.