Provider Demographics
NPI:1316658727
Name:RODGERS, OLGA MARIE (APRN)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:MARIE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10901 GREENBELT HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-1888
Mailing Address - Country:US
Mailing Address - Phone:502-212-8741
Mailing Address - Fax:
Practice Address - Street 1:10901 GREENBELT HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-1888
Practice Address - Country:US
Practice Address - Phone:502-212-8741
Practice Address - Fax:502-933-0856
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3018748363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily