Provider Demographics
NPI:1285006494
Name:ROGERS, BONNIE
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18947 JOHN J WILLIAMS HWY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4314
Mailing Address - Country:US
Mailing Address - Phone:302-644-0690
Mailing Address - Fax:302-644-0695
Practice Address - Street 1:18947 JOHN J WILLIAMS HIGHWAY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4314
Practice Address - Country:US
Practice Address - Phone:302-644-0690
Practice Address - Fax:302-644-0695
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0045214163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse