Provider Demographics
NPI:1114476843
Name:ROGERS, STEPHANIE (FNP-BC, APN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:FNP-BC, APN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:HUMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 NATIONAL DR
Mailing Address - Street 2:APT 95
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-6860
Mailing Address - Country:US
Mailing Address - Phone:269-313-3596
Mailing Address - Fax:
Practice Address - Street 1:4432 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-3977
Practice Address - Country:US
Practice Address - Phone:269-313-3596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily