Provider Demographics
NPI:1306107354
Name:ROGERS, CAROL EISENHAUER (GNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:EISENHAUER
Last Name:ROGERS
Suffix:
Gender:F
Credentials:GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 S YOSEMITE ST FL 6
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5139
Mailing Address - Country:US
Mailing Address - Phone:719-728-0365
Mailing Address - Fax:844-881-9988
Practice Address - Street 1:8280 MONTGOMERY RD
Practice Address - Street 2:SUITE 306
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6101
Practice Address - Country:US
Practice Address - Phone:937-499-3567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992961-NP363LG0600X
OH15391-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology