Individual
DECOLIA RONIC ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1214 COOLIDGE BLVD, LAFAYETTE, LA 70503-2621
(337) 289-7991
Mailing address
926 FRISKY DR, BRANDON, MS 39047-7070
(601) 575-4069
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
211857
LA
363LG0600X
Gerontology Nurse Practitioner
Primary
211857
LA
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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