| NPI | 1720646227 |
|---|---|
| Former Name | NICOLE ANN ROGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5011996) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2024-01-17 |