Provider Demographics
NPI:1740318823
Name:ROGERS, LAURA ELIZABETH (MS, EDS, MSN, PMHNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELIZABETH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS, EDS, MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2130 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3834
Mailing Address - Country:US
Mailing Address - Phone:970-252-3200
Mailing Address - Fax:970-252-3208
Practice Address - Street 1:710 N TAYLOR ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2244
Practice Address - Country:US
Practice Address - Phone:970-641-0229
Practice Address - Fax:970-641-2949
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60742538363LP0808X
TN17133363LP0808X
COAPN.0992318-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health