Basic Information
| Provider Information | |||||||||
| NPI: | 1841763059 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROGERS | ||||||||
| FirstName: | REBEKAH | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 EVERGREEN CIR NW | ||||||||
| Address2: | |||||||||
| City: | BONDURANT | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500352604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156120981 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12499 UNIVERSITY AVE STE 280 | ||||||||
| Address2: | |||||||||
| City: | CLIVE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503258288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152456425 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2019 | ||||||||
| LastUpdateDate: | 01/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | F01190497 | IA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 363L00000X | F01190497 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.