Healthcare Provider Details

I. General information

NPI: 1851006837
Provider Name (Legal Business Name): REBECCA ROGERS STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BOSTON MEDICAL CENTER PLACE
BOSTON MA
02118
US

IV. Provider business mailing address

140 COMMONWEALTH AVE
CHESTNUT HILL MA
02467-3858
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-6950
  • Fax:
Mailing address:
  • Phone: 617-552-2756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN2309184
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2309184
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: