Provider Demographics
NPI:1982413316
Name:ROUGIER, BETTY-ANN AGATHA
Entity type:Individual
Prefix:
First Name:BETTY-ANN
Middle Name:AGATHA
Last Name:ROUGIER
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 1:1125 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-2669
Mailing Address - Country:US
Mailing Address - Phone:630-937-3690
Mailing Address - Fax:
Practice Address - Street 1:1676 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1488
Practice Address - Country:US
Practice Address - Phone:630-937-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY496955163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse