Individual
MARY S ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5875 BREMO RD, SUITE G-5, RICHMOND, VA 23226-1934
(804) 287-7840
(804) 287-7845
Mailing address
5855 BREMO RD, STE 506, RICHMOND, VA 23226-1925
(804) 287-7840
(804) 287-7845
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024105235
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001105235
RN LICENSE
VA
01
—
0017000649
NP PRESCRIPTIVE AUTHORITY
VA
01
—
0024105235
NURSE PRACTITIONER LICENS
VA
Enumeration date
07/25/2006
Last updated
03/07/2023
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