Rodgers, Jeannette Lillian

Rodgers, Jeannette Lillian is an sole proprietor health care provider with primary practice located at 16 Gary Street , Port Jefferson Station NY 11776. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Rodgers, Jeannette Lillian can be contacted via phone (631) 828-2792.

Contact Information

Primary practice address
16 Gary Street Port Jefferson Station NY 11776
Phone: (631) 828-2792
Fax: (631) 828-2792
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 371900 1 New York

Profile Details

NPI number 1033309349
LBN Legal business name Rodgers, Jeannette Lillian
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2007
Last updated Aug 1st, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033309349 NPPES
New York MEDICAID 02559406

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