Provider Demographics
NPI:1316715311
Name:RODARTE-ROGALSKI, JULIA REGINA
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:REGINA
Last Name:RODARTE-ROGALSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 BAY RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2445
Mailing Address - Country:US
Mailing Address - Phone:989-799-6542
Mailing Address - Fax:989-799-6867
Practice Address - Street 1:3665 BAY RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2445
Practice Address - Country:US
Practice Address - Phone:989-799-6542
Practice Address - Fax:989-799-6867
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2L8F4H9374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide