MEDICARE: SARAH K ROGERS LLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1750658423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH K ROGERS LLC

Provider Business Mailing Address
First Line	:	11813 VIENNA APPLE RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7574
Country	:	US
Telephone Number	:	817-562-4733
Fax Number	:	415-574-5290

Provider Business Practice Location Address
First Line	:	11813 VIENNA APPLE RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7574
Country	:	US
Telephone Number	:	817-562-4733
Fax Number	:	415-574-5290

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH K ROGERS
Credential	:	FNP
Telephone Number	:	817-562-4733

Provider Enumeration Date	:	11/25/2011
Last Update Date	:	11/25/2011

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