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General NPI Number Information
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NPI Number | 1114476843
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Entity Type | Individual
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Provider Name | STEPHANIE ROGERS FNP-BC, APN
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Gender | Female
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/21/2017
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Provider Practice Location Address
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Address Line | 4432 VETERANS PKWY
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City | MURFREESBORO
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State | TN
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Zip | 37128-3977
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Country | US
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Telephone | 269-313-3596
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Fax |
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Provider Business Mailing Address
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Address Line | 207 NATIONAL DR APT 95
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City | MURFREESBORO
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State | TN
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Zip | 37128-6860
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Country | US
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Telephone | 269-313-3596
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 21779
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License Number State | TN
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