Basic Information
| Provider Information | |||||||||
| NPI: | 1053809087 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROGERS | ||||||||
| FirstName: | AMBER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5559 RAIDERS RD | ||||||||
| Address2: | |||||||||
| City: | FRAZEYSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 438229431 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5559 RAIDERS RD | ||||||||
| Address2: | |||||||||
| City: | FRAZEYSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 438229431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8556927247 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2018 | ||||||||
| LastUpdateDate: | 04/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN.442357 | OH | Y | Nursing Service Providers | Registered Nurse |
No ID Information.