Provider Demographics
NPI:1801873526
Name:RODGERS, COURTNEY LEA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:LEA
Last Name:RODGERS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:LEA
Other - Last Name:CABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:507 43RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6654
Mailing Address - Country:US
Mailing Address - Phone:507-281-4214
Mailing Address - Fax:
Practice Address - Street 1:1216 SECOND STREET SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-255-5731
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117643-8183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist