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Individual

DR. AMANDA BONIFACE ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, ANP-C

Contact information

Practice address
2995 REIDVILLE RD STE 210, SPARTANBURG, SC 29301-5631
(864) 253-8140
(864) 587-0051
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18343
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP2544
SC
01
SCP0295019
MEDICARE PIN
SC
Enumeration date
07/02/2013
Last updated
02/08/2023
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