Healthcare Provider Details

I. General information

NPI: 1568045292
Provider Name (Legal Business Name): DLYNN DANIELLE ROGERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 INDUSTRIAL BLVD STE 101
HAWKINSVILLE GA
31036-8035
US

IV. Provider business mailing address

3371 FAIR HAVEN RD
EASTMAN GA
31023-8451
US

V. Phone/Fax

Practice location:
  • Phone: 478-888-1737
  • Fax:
Mailing address:
  • Phone: 478-231-7293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR144245
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: