Provider Demographics
NPI:1184038119
Name:ROGERS, BROOKE (DNP,FNP-C)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DNP,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 US HIGHWAY 27 S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2169
Mailing Address - Country:US
Mailing Address - Phone:863-385-7183
Mailing Address - Fax:863-385-0088
Practice Address - Street 1:727 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2169
Practice Address - Country:US
Practice Address - Phone:863-385-7183
Practice Address - Fax:863-385-0088
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLARNP9325944363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program