Healthcare Provider Details

I. General information

NPI: 1396081360
Provider Name (Legal Business Name): JAMIE ANN ROGERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29826 HAUN RD STE 300
MENIFEE CA
92586-6547
US

IV. Provider business mailing address

1545 W FLORIDA AVE
HEMET CA
92543-3814
US

V. Phone/Fax

Practice location:
  • Phone: 951-679-7022
  • Fax: 888-379-6223
Mailing address:
  • Phone: 951-791-1111
  • Fax: 888-856-3893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1212225
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: