Individual
MS. SAMANTHA RAE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PMH
Contact information
Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2999
(410) 740-7890
Mailing address
9515 SYLVAN STILL RD APT A, LAUREL, MD 20723-1542
(518) 248-2515
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R198756
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R198756
NURSE PRACTITIONER LICENSE
MD
Enumeration date
09/19/2022
Last updated
09/19/2022
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