Provider Demographics
NPI:1902235666
Name:ROGERS, HALLIE B (PCD(DONA), CLC, CLEC)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:B
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PCD(DONA), CLC, CLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1183 BLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2004
Mailing Address - Country:US
Mailing Address - Phone:651-747-6954
Mailing Address - Fax:
Practice Address - Street 1:1183 BLAIR AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2004
Practice Address - Country:US
Practice Address - Phone:651-747-6954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula