Provider Demographics
NPI:1396576427
Name:RODGERS, MADELEINE LYNNETTE (PHD, RN, CDCES, EMT)
Entity type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:LYNNETTE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:PHD, RN, CDCES, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7798 W BOARDWALK
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-6921
Mailing Address - Country:US
Mailing Address - Phone:409-273-0152
Mailing Address - Fax:
Practice Address - Street 1:7798 W BOARDWALK
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-6921
Practice Address - Country:US
Practice Address - Phone:409-273-0152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-10
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605590163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator