Healthcare Provider Details

I. General information

NPI: 1093390866
Provider Name (Legal Business Name): LINDSEY JO ROGERS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S LAFAYETTE ST
STARKVILLE MS
39759-3209
US

IV. Provider business mailing address

3628 24TH AVE
MERIDIAN MS
39305-3833
US

V. Phone/Fax

Practice location:
  • Phone: 662-323-5588
  • Fax: 662-323-5552
Mailing address:
  • Phone: 601-527-7544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number904514
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: