Healthcare Provider Details

I. General information

NPI: 1881096642
Provider Name (Legal Business Name): AARON PHILLIP ROGERS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W MAPLE ST STE B
FARMINGTON NM
87401-5967
US

IV. Provider business mailing address

622 W MAPLE ST STE B
FARMINGTON NM
87401-6589
US

V. Phone/Fax

Practice location:
  • Phone: 505-566-5109
  • Fax:
Mailing address:
  • Phone: 505-327-4867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-02471
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: