Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP127001 | TX |
NPI | 1043659717 |
---|---|
Provider Name | Laura C. Rodgers |
First Address | Center, TX 75935-3414 |
Second Address | Center, TX 75935-3414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 20/05/2021 |