Provider Demographics
NPI:1932999158
Name:RODGERS, MELANIE JENEE (CERTIFICATE)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:JENEE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:CERTIFICATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W MAIN ST
Mailing Address - Street 2:RODGERSFAM05@GMAIL.COM
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-9752
Mailing Address - Country:US
Mailing Address - Phone:541-690-7237
Mailing Address - Fax:
Practice Address - Street 1:201 W MAIN ST
Practice Address - Street 2:RODGERSFAM05@GMAIL.COM
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-9752
Practice Address - Country:US
Practice Address - Phone:541-690-7237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR111245175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist