Provider Demographics
NPI:1275073942
Name:ROGERS, ERICA (NP-C)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-1762
Mailing Address - Country:US
Mailing Address - Phone:269-783-3052
Mailing Address - Fax:269-783-2074
Practice Address - Street 1:520 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1762
Practice Address - Country:US
Practice Address - Phone:269-783-3052
Practice Address - Fax:269-783-2074
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704227814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily