Healthcare Provider Details

I. General information

NPI: 1740560432
Provider Name (Legal Business Name): NICOLE ALYSSE ROGERS PMHNP, FNP-C, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE A BELL ROGERS

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 PEBBLE VALLEY PL
DOVER DE
19904-9465
US

IV. Provider business mailing address

300 S NEW ST
DOVER DE
19904-6726
US

V. Phone/Fax

Practice location:
  • Phone: 302-632-7307
  • Fax:
Mailing address:
  • Phone: 302-857-6729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000576
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010614
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0102511-C-NP
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0035595
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: