Individual
MR. JUSTIN EARL ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, AGACNP-BC
Contact information
Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1641
(928) 771-5470
Mailing address
1210 HAISLEY RD, PRESCOTT, AZ 86303-5379
(928) 899-8631
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RNP235419
AZ
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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