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General NPI Number Information
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NPI Number | 1154141430
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Entity Type | Individual
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Provider Name | DORTHEA YOLANDA ROGERS APRN
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Gender | Female
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 125 GOVERNORS SQ STE B
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4871
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Country | US
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Telephone | 678-423-5500
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Fax | 678-271-3204
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Provider Business Mailing Address
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Address Line | 865 WAGON WHEEL CIR
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-9622
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Country | US
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Telephone | 470-856-4105
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN311743
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License Number State | GA
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