Provider Demographics
NPI:1093879264
Name:ROGERS, REGINA T (APRN)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:T
Last Name:ROGERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:265 CHANDLERS RIDGE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-6436
Mailing Address - Country:US
Mailing Address - Phone:706-876-2130
Mailing Address - Fax:706-876-2168
Practice Address - Street 1:1575 CHATTANOOGA AVE
Practice Address - Street 2:STE 1
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2671
Practice Address - Country:US
Practice Address - Phone:706-876-2130
Practice Address - Fax:706-876-2168
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN144953NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily