Healthcare Provider Details

I. General information

NPI: 1245947845
Provider Name (Legal Business Name): DANIELLE L. ROGERS C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8877 MENTOR AVE
MENTOR OH
44060-6211
US

IV. Provider business mailing address

PO BOX 381468
GERMANTOWN TN
38183-1468
US

V. Phone/Fax

Practice location:
  • Phone: 440-205-1225
  • Fax: 440-205-1275
Mailing address:
  • Phone: 901-377-8219
  • Fax: 901-328-1355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0032620
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: