Provider Demographics
NPI:1528638947
Name:ROGERS, CASSANDRA COMBS
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:COMBS
Last Name:ROGERS
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 1:8134 MISTY OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-6044
Mailing Address - Country:US
Mailing Address - Phone:225-650-4200
Mailing Address - Fax:
Practice Address - Street 1:8134 MISTY OAKS AVE
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-6044
Practice Address - Country:US
Practice Address - Phone:225-650-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA003302214343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)