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General NPI Number Information
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NPI Number | 1770306136
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Entity Type | Individual
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Provider Name | SAMANTHA ROGERS
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 727 E 1ST ST
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City | MINDEN
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State | NE
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Zip | 68959-1705
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Country | US
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Telephone | 302-832-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 1098 EVERGREEN DR
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City | PHILLIPSBURG
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State | KS
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Zip | 67661-7060
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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 | 115700
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License Number State | NE
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