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General NPI Number Information
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NPI Number | 1053855684
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Entity Type | Individual
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Provider Name | ALEA NICOLE ROGERS APRN
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Gender | Female
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Dates
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Enumeration Date | 12/16/2016
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 620 S MADISON ST STE 304
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City | ENID
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State | OK
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Zip | 73701-7270
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Country | US
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Telephone | 580-977-1902
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Fax | 580-233-6106
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Provider Business Mailing Address
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Address Line | 3001 QUAIL SPRINGS PKWY FL 5
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-2640
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Country | US
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Telephone | 580-977-1902
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Fax | 580-233-6106
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 92573
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License Number State | OK
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