Provider Demographics
NPI:1154806305
Name:RODGERS, CHASITY ANN (LVN)
Entity type:Individual
Prefix:
First Name:CHASITY
Middle Name:ANN
Last Name:RODGERS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12919 STATE HIGHWAY 7 E
Mailing Address - Street 2:
Mailing Address - City:JOAQUIN
Mailing Address - State:TX
Mailing Address - Zip Code:75954-4007
Mailing Address - Country:US
Mailing Address - Phone:936-269-9224
Mailing Address - Fax:
Practice Address - Street 1:12919 STATE HIGHWAY 7 E
Practice Address - Street 2:
Practice Address - City:JOAQUIN
Practice Address - State:TX
Practice Address - Zip Code:75954-4007
Practice Address - Country:US
Practice Address - Phone:936-269-9224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313142164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse