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General NPI Number Information
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NPI Number | 1275861791
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Entity Type | Individual
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Provider Name | TERRY M. ROGERS FNP
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Gender | Male
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 935 SPRING CREEK RD SUITE 205
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City | CHATTANOOGA
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State | TN
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Zip | 37412-3993
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Country | US
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Telephone | 423-893-9787
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Fax | 423-893-9037
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Provider Business Mailing Address
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Address Line | 935 SPRING CREEK RD SUITE 205
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City | CHATTANOOGA
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State | TN
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Zip | 37412-3993
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Country | US
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Telephone | 423-893-9787
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Fax | 423-893-9037
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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 | 14640
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN95717
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License Number State | TN
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