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General NPI Number Information
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NPI Number | 1568690964
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Entity Type | Organization
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Legal Business Name | INDEPENDENT APN, LLC
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 11609 LAWNDALE DR
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City | PARMA HEIGHTS
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State | OH
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Zip | 44130-4356
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Country | US
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Telephone | 440-666-3707
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Fax |
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Provider Business Mailing Address
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Address Line | 11609 LAWNDALE DR
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City | PARMA
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State | OH
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Zip | 44130-4356
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Country | US
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Telephone | 440-666-3707
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DANA LYNN ROGERS
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Credential | ANP/GNP-BC
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Telephone | 440-666-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | COA09982-NP
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License Number State | OH
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