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General NPI Number Information
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NPI Number | 1780817973
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Entity Type | Individual
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Provider Name | MARIE L. ROGERS RN, MSN, FNP
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Gender | Female
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 339 COLLEGE AVE
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City | SANTA ROSA
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State | CA
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Zip | 95405
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Country | US
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Telephone | 707-823-3029
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Fax |
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Provider Business Mailing Address
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Address Line | 2267 SCHAEFFER RD
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City | SEBASTOPOL
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State | CA
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Zip | 95472
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Country | US
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Telephone | 707-823-3029
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Fax | 707-823-3029
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 15365
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License Number State | CA
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