Doctor Name: | SUSAN JILL ROGERS |
NPI Number: | 1134559354 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, FNP-BC |
License Number: | 26148 |
Business Practice Address: | 8 Lee St Moorefield, WV - 268361091 |
Business Phone Number: | 3045303700 |
Business Fax Number: | 3042857126 |
Mailing Address: | Po Box 780, MORGANTOWN |
State: | WV |
Postal Code: | 265070780 |
Phone Number: | 3042857101 |
Fax Number: | 3042857126 |
NPI Enumeration Date: | 11/25/2013 |
NPI Last Update Date: | 11/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26148 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |