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General NPI Number Information
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NPI Number | 1144318957
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Entity Type | Individual
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Provider Name | DEBRA LYNN RODGERS NP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 6896 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-2843
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Country | US
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Telephone | 951-787-4885
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Fax | 951-787-4962
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Provider Business Mailing Address
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Address Line | 27646 CORTE DEL SOL
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City | MORENO VALLEY
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State | CA
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Zip | 92555-5924
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Country | US
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Telephone | 951-243-3149
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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 | 15987
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License Number State | CA
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