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Individual

MS. THERESA LYNN ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6465 S YALE AVE STE 910, TULSA, OK 74136-7811
(918) 502-3200
(918) 502-3205
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1101
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100131930A
OK
Enumeration date
06/08/2006
Last updated
06/17/2022
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