MEDICARE: MS. CORI LYN ROGERS MSN, RN, CPNP

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	363LP0200X	Pediatric Nurse Practitioner	3394	SC
2	363LP0200X	Pediatric Nurse Practitioner	APN0000011110	TN

General Provider Information

NPI Number	:	1982707501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CORI LYN ROGERS MSN, RN, CPNP

Provider Business Mailing Address
First Line	:	3312 MAYBANK HWY STE B
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-4818
Country	:	US
Telephone Number	:	843-894-3490
Fax Number	:	334-506-0228

Provider Business Practice Location Address
First Line	:	3312 MAYBANK HWY STE B
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-4818
Country	:	US
Telephone Number	:	843-894-3490
Fax Number	:	334-506-0228

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	08/12/2025

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