Provider Demographics
NPI:1346878139
Name:RODGERS, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:RODGERS
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:PO BOX 1328
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81302-1328
Mailing Address - Country:US
Mailing Address - Phone:970-335-1004
Mailing Address - Fax:
Practice Address - Street 1:150 MERCURY VILLAGE DR
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8955
Practice Address - Country:US
Practice Address - Phone:970-335-2342
Practice Address - Fax:970-335-2438
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0070545207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine