Susan Elizebeth Rogge
Individual provider Active NPI Licensed Practical Nurse · Chilcoot, CA
NPI 1295975332 · NPPES record last updated Mar 3, 2009
Key facts
- NPI
- 1295975332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 11160LPN (NV)
- Practice address
- 94146 Chilcoot Ave.
Chilcoot, CA 96105 - Phone
- (530) 993-4339
- NPI assigned
- Mar 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11160LPN | NV | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 11160LPN | NV | Yes |
Addresses
Primary practice location
94146 Chilcoot Ave.
Chilcoot, CA 96105
Mailing address
PO Box 73
Chilcoot, CA 96105-0073
Phone (530) 993-4339
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.