Individual
PATRICIA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(386) 236-3200
Mailing address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(386) 236-3200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
26NJ00066900
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
26NJ00066900
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9415718
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6070190
—
NJ
Enumeration date
10/05/2006
Last updated
10/16/2015
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