Individual
SHIRLEY GWEN ROGERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH,BSN,RN,CDE
Contact information
Practice address
4710 S FLORIDA AVE, LAKELAND, FL 33813-2165
(863) 284-3950
(863) 284-3951
Mailing address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 284-1604
(863) 687-1412
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
9170975
FL
163WD0400X
Diabetes Educator Registered Nurse
917905
FL
163WD0400X
Diabetes Educator Registered Nurse
RN9170975
FL
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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