Individual
HOLLY D. ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
800 N FANT ST., ANDERSON, SC 29621
(864) 512-1335
Mailing address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1335
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19519
SC
364SE0003X
Emergency Clinical Nurse Specialist
19519
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003167486A
—
GA
05
—
NP3357
—
SC
01
—
NPI #
TRICARE - AFFILIATION
SC
Enumeration date
06/18/2015
Last updated
10/15/2020
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