Provider Demographics
NPI:1932413440
Name:ROGONJIC, JEANNINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:
Last Name:ROGONJIC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 CRANOVER RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2321
Mailing Address - Country:US
Mailing Address - Phone:216-382-7145
Mailing Address - Fax:
Practice Address - Street 1:1375 CRANOVER RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2321
Practice Address - Country:US
Practice Address - Phone:216-382-7145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN326776163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical