Provider Demographics
NPI:1316342660
Name:ROGERS, DENA MARIE (RD)
Entity type:Individual
Prefix:MS
First Name:DENA
Middle Name:MARIE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:DENA
Other - Middle Name:ROGERS
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:400 E GRAY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1740
Mailing Address - Country:US
Mailing Address - Phone:502-574-6580
Mailing Address - Fax:502-574-5286
Practice Address - Street 1:908 W BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2029
Practice Address - Country:US
Practice Address - Phone:502-595-3121
Practice Address - Fax:502-595-4532
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY714497133V00000X
KY0096133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered