Individual
MRS. VANESSA S ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8210 LOUISIANA BLVD. NE, SUITE C, ALBUQUERQUE, NM 87113-1761
(505) 858-1222
(505) 858-1224
Mailing address
9484 PARKSIDE DR, WASHINGTON TOWNSHIP, OH 45458-3545
(937) 941-7480
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004464RX
OH
363AM0700X
Medical Physician Assistant
50.004464
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144513
—
OH
05
—
13003577
—
NM
Enumeration date
06/30/2008
Last updated
08/06/2019
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