MEDICARE: BETH ROGERS NP

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	163WG0000X	General Practice Registered Nurse	RN9657118	FL
2	363LF0000X	Family Nurse Practitioner	AP106546	TX
3	363LW0102X	Women's Health Nurse Practitioner	587674	TX
4	363LF0000X	Family Nurse Practitioner	APRN9429777	FL

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	:	1386884393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH ROGERS NP

Provider Business Mailing Address
First Line	:	704 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	SEFFNER
State	:	FL
Zip	:	33584-4534
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	SEFFNER
State	:	FL
Zip	:	33584-4534
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

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

Provider Enumeration Date	:	03/03/2009
Last Update Date	:	04/15/2024

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Directions to “ BETH ROGERS NP” Practice Location

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