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General NPI Number Information
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NPI Number | 1164634861
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Entity Type | Individual
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Provider Name | TERESA A ROGERS RN
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2279 PARKSVILLE RD
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City | BENTON
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State | TN
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Zip | 37307-3803
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Country | US
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Telephone | 423-338-4533
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BRANNON LN
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City | BENTON
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State | TN
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Zip | 37307-5850
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Country | US
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Telephone | 423-338-4533
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN0000074330
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License Number State | TN
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