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NPI Code Detail

MEDICARE: DR. TERI CAROL RODGERS DNP, PMHNP-C, FNP-C

MEDICARE:  DR. TERI CAROL RODGERS  DNP, PMHNP-C, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner201161NC
2363LP0808XPsychiatric/Mental Health Nurse Practitioner201161NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2500028327OTHERNCRAILROAD MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1134183155
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERI CAROL RODGERS DNP, PMHNP-C, FNP-C
Provider Business Mailing Address
First Line : 2509 STEEPLECHASE RD
Second Line :
City : GASTONIA
State : NC
Zip : 28056-0315
Country : US
Telephone Number : 47-718-4755
Fax Number :
Provider Business Practice Location Address
First Line : 310 MOCKSVILLE AVE
Second Line :
City : SALISBURY
State : NC
Zip : 28144-3328
Country : US
Telephone Number : 704-762-9630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 07/06/2022

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Directions to “ DR. TERI CAROL RODGERS DNP, PMHNP-C, FNP-C” Practice Location

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