Healthcare Provider Details

I. General information

NPI: 1336637354
Provider Name (Legal Business Name): SHARLENE ELIZABETH ROGERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3496 US HWY 82
MAYHILL NM
88339
US

IV. Provider business mailing address

PO BOX 22
MAYHILL NM
88339
US

V. Phone/Fax

Practice location:
  • Phone: 575-687-4232
  • Fax: 949-703-8332
Mailing address:
  • Phone: 575-687-4232
  • Fax: 949-703-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP-03555
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberCNP-03555
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: