Individual
MS. SHANAYE LEJUANA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
109 TOULON CT, FAIRVIEW HEIGHTS, IL 62208-3819
(618) 236-3660
Mailing address
109 TOULON CT, FAIRVIEW HEIGHTS, IL 62208-3819
(618) 236-3660
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.355485
IL
163W00000X
Registered Nurse
2006026912
MO
163W00000X
Registered Nurse
Primary
RN171260
GA
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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