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Individual

MRS. OLIVIA C ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1968 IVY CREEK BLVD BLDG 2503, DURHAM, NC 27707-3455
(919) 765-1090
(919) 765-3498
Mailing address
1968 IVY CREEK BLVD BLDG 2503, DURHAM, NC 27707-3455
(919) 765-1090
(919) 765-3498

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5006425
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
216597
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1770981003
NC
01
19A8U
BCBS NC
NC
Enumeration date
12/19/2014
Last updated
02/21/2022
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