MEDICARE: MIKAILIA ASHLEY ROGERS RN

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	163W00000X	Registered Nurse	9385660	FL

General Provider Information

NPI Number	:	1437008646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKAILIA ASHLEY ROGERS RN

Provider Business Mailing Address
First Line	:	10 PERIMETER SUMMIT BLVD NE UNIT 2411
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-1481
Country	:	US
Telephone Number	:	321-208-5478
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 PERIMETER SUMMIT BLVD NE UNIT 2411
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-1481
Country	:	US
Telephone Number	:	321-208-5478
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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