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General NPI Number Information
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NPI Number | 1649679390
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Entity Type | Individual
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Provider Name | AMY LYNN ROGERS FNP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 13975 MONO WAY STE G
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City | SONORA
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State | CA
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Zip | 95370-2824
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Country | US
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Telephone | 209-754-6262
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 939
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City | ANGELS CAMP
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State | CA
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Zip | 95222-0939
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Country | US
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Telephone | 209-754-6262
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Fax | 209-736-1814
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 541282
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95001186
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License Number State | CA
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