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General NPI Number Information
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NPI Number | 1689048902
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Entity Type | Individual
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Provider Name | JAIME L ROGERS ACNP
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Gender | Female
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 601 JOHN ST STE M-510
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City | KALAMAZOO
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State | MI
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Zip | 49007-5341
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Country | US
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Telephone | 269-341-7762
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Fax |
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Provider Business Mailing Address
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Address Line | 601 JOHN STREET BOX 39
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City | KALAMAZOO
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State | MI
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Zip | 49007-5348
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2335194
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704385590
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License Number State | MI
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