MEDICARE: JILL ANNE RODGERS FNP

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	SP011471	PA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP020031	PA

General Provider Information

NPI Number	:	1851662332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL ANNE RODGERS FNP

Provider Business Mailing Address
First Line	:	100 SHENANGO AVE
Second Line	:
City	:	SHARON
State	:	PA
Zip	:	16146-1503
Country	:	US
Telephone Number	:	724-253-3428
Fax Number	:	724-253-3029

Provider Business Practice Location Address
First Line	:	3339 PERRY HIGHWAY
Second Line	:
City	:	SHEAKLEYVILLE
State	:	PA
Zip	:	16151
Country	:	US
Telephone Number	:	724-253-3428
Fax Number	:	724-253-3029

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

Provider Enumeration Date	:	01/16/2012
Last Update Date	:	06/13/2023

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