Provider Demographics
NPI:1477322055
Name:ROGERS, KELSI MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:KELSI
Middle Name:MARIE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 VISTA VIEW DR N
Mailing Address - Street 2:
Mailing Address - City:NASHPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43830-9308
Mailing Address - Country:US
Mailing Address - Phone:740-586-8166
Mailing Address - Fax:
Practice Address - Street 1:2270 VISTA VIEW DR N
Practice Address - Street 2:
Practice Address - City:NASHPORT
Practice Address - State:OH
Practice Address - Zip Code:43830-9308
Practice Address - Country:US
Practice Address - Phone:740-586-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035131363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner