Healthcare Provider Details

I. General information

NPI: 1285577163
Provider Name (Legal Business Name): DANIELLE MARIE ROGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N WARREN ST
TRENTON NJ
08618-4741
US

IV. Provider business mailing address

321 N WARREN ST
TRENTON NJ
08618-4741
US

V. Phone/Fax

Practice location:
  • Phone: 609-278-5900
  • Fax:
Mailing address:
  • Phone: 609-278-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95035992
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035992
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: