Basic Information
| Provider Information | |||||||||
| NPI: | 1174688170 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODGERS | ||||||||
| FirstName: | ANN | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14780 W MOUNTAIN VIEW BLVD | ||||||||
| Address2: | STE 110 | ||||||||
| City: | SURPRISE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853747280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6233747774 | ||||||||
| FaxNumber: | 8554206361 | ||||||||
| Practice Location | |||||||||
| Address1: | 5575 E RIVER RD STE 121-222 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857506743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5205298387 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 01/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN111109 | AZ | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 1157 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.