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General NPI Number Information
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NPI Number | 1851914691
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Entity Type | Individual
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Provider Name | ANDREA FLETCHER ROGERS
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 167 HAVEN DR
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City | NORFOLK
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State | VA
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Zip | 23503-4839
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Country | US
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Telephone | 757-675-1860
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Fax |
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Provider Business Mailing Address
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Address Line | 167 HAVEN DR
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City | NORFOLK
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State | VA
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Zip | 23503-4839
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 928021
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 928021
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2472B0301X
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Taxonomy Name | Biomedical Engineering Technician
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License Number | 928021
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 928021
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 928021
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License Number State | VA
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