MEDICARE: MRS. SIOBAIN KAY ROGERS MSN, FNP-C, CCRN

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
1	363L00000X	Nurse Practitioner	204428	LA
2	363LF0000X	Family Nurse Practitioner	R45403	ND
3	363LF0000X	Family Nurse Practitioner	781923	TX
4	363LP2300X	Primary Care Nurse Practitioner	AP130283	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CVDB81	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134504426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SIOBAIN KAY ROGERS MSN, FNP-C, CCRN

Provider Business Mailing Address
First Line	:	538 BROADWAY
Second Line	:
City	:	WINNIE
State	:	TX
Zip	:	77665-7600
Country	:	US
Telephone Number	:	409-296-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 IH 10 N STE 112
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-2560
Country	:	US
Telephone Number	:	409-239-5139
Fax Number	:	409-347-8856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2015
Last Update Date	:	01/11/2022

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Directions to “ MRS. SIOBAIN KAY ROGERS MSN, FNP-C, CCRN” Practice Location

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