Individual
RUSSELL C ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 11TH AVE S, BIRMINGHAM, AL 35205-3423
(205) 934-3411
Mailing address
1201 11TH AVE S, BIRMINGHAM, AL 35205-3423
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-166129
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-166129
AL
Other
Enumeration date
10/28/2021
Last updated
01/15/2024
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