Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1326578071 |
---|---|
Provider Name | Emily Jean Rogers |
First Address | Brentwood, TN 37027-5274 |
Second Address | Brentwood, TN 37027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2017 |
Last Update Date | 15/06/2017 |