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General NPI Number Information
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NPI Number | 1639723711
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Entity Type | Individual
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Provider Name | AMANDA MARIE ROGERS APNP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2019
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 777 N JEFFERSON ST STE 408
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City | MILWAUKEE
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State | WI
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Zip | 53202-3713
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Country | US
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Telephone | 415-360-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 2914 S MABBETT AVE
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City | MILWAUKEE
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State | WI
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Zip | 53207-2525
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Country | US
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Telephone | 630-379-2373
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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 | 209027460
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 78942
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 9411-33
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 101.0137083TELE
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License Number State | VT
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | TPAN1844
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1165069
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License Number State | TX
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