Individual
MRS. LATESA M ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 CHAPEL HILL RD, DOUGLASVILLE, GA 30135-1739
(404) 969-1719
(404) 969-1770
Mailing address
3400 CHAPEL HILL RD, DOUGLASVILLE, GA 30135-1739
(404) 969-1719
(404) 969-1770
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
0030054791
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
HOME CARE
—
Enumeration date
03/25/2021
Last updated
03/29/2021
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