Provider Demographics
NPI:1275689101
Name:ROGERS, GINGER (ARNP)
Entity Type:Individual
Prefix:DR
First Name:GINGER
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13927 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-4044
Mailing Address - Country:US
Mailing Address - Phone:402-690-9628
Mailing Address - Fax:
Practice Address - Street 1:13927 MONROE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-4044
Practice Address - Country:US
Practice Address - Phone:402-690-9628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE APRN 1758363LG0600X
IAIA APRN J-113706363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1723OtherMEDICARE GROUP PTAN
IAIB1723001OtherMEDICARE IND PTAN