Provider Demographics
NPI:1114765500
Name:ROGERS, YAMISE KASONJA
Entity type:Individual
Prefix:
First Name:YAMISE
Middle Name:KASONJA
Last Name:ROGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MICHIGAN AVE NE APT 32P
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1053
Mailing Address - Country:US
Mailing Address - Phone:202-702-1093
Mailing Address - Fax:
Practice Address - Street 1:132 MICHIGAN AVE NE APT 32P
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1053
Practice Address - Country:US
Practice Address - Phone:202-702-1093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide