MEDICARE: BRANDY ROGERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	168952	TN
2	363LF0000X	Family Nurse Practitioner	32420	TN
3	363LF0000X	Family Nurse Practitioner	168952	TN

General Provider Information

NPI Number	:	1487377131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDY ROGERS

Provider Business Mailing Address
First Line	:	60 BRAZELTON ST UNIT 6
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-3080
Country	:	US
Telephone Number	:	731-438-3090
Fax Number	:	731-256-0757

Provider Business Practice Location Address
First Line	:	60 BRAZELTON ST UNIT 6
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-3080
Country	:	US
Telephone Number	:	731-607-2388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	12/17/2025

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Directions to “ BRANDY ROGERS ” Practice Location

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