MEDICARE: MRS. SHARON LYNN ROGERS APN

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	364SA2200X	Adult Health Clinical Nurse Specialist	S02231 CNS	AR

General Provider Information

NPI Number	:	1518123868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON LYNN ROGERS APN

Provider Business Mailing Address
First Line	:	7648 VICTORY BLVD
Second Line	:
City	:	NEWPORT
State	:	AR
Zip	:	72112-8912
Country	:	US
Telephone Number	:	870-512-7833
Fax Number	:	870-512-7715

Provider Business Practice Location Address
First Line	:	1200 MCLAIN ST
Second Line	:
City	:	NEWPORT
State	:	AR
Zip	:	72112-3534
Country	:	US
Telephone Number	:	870-523-9852
Fax Number	:	870-523-3583

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

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	08/05/2008

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