Provider Demographics
NPI:1124234828
Name:ROGERS, CYNTHIA LOVERN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOVERN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 ALEX DENTON DR
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-3218
Mailing Address - Country:US
Mailing Address - Phone:918-775-5843
Mailing Address - Fax:918-775-4479
Practice Address - Street 1:612 N OAK ST
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-2827
Practice Address - Country:US
Practice Address - Phone:918-775-6201
Practice Address - Fax:918-775-4479
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0034941163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory