Provider Demographics
NPI:1194519090
Name:ROGERS, ANGELICA S
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:S
Last Name:ROGERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 AMES CROSSING RD STE 200
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2498
Mailing Address - Country:US
Mailing Address - Phone:800-858-0723
Mailing Address - Fax:
Practice Address - Street 1:2900 AMES CROSSING RD STE 200
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2498
Practice Address - Country:US
Practice Address - Phone:800-858-0723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000043481183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician