Individual
MR. LEROY F ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
135114
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN0774
BLUE CROSS/
—
Enumeration date
07/26/2006
Last updated
07/08/2007
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