Provider Demographics
NPI:1477800035
Name:RODGERS, ADRIANE (NP)
Entity Type:Individual
Prefix:
First Name:ADRIANE
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LITTLETON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3115
Mailing Address - Country:US
Mailing Address - Phone:978-577-1946
Mailing Address - Fax:978-692-4716
Practice Address - Street 1:133 LITTLETON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3115
Practice Address - Country:US
Practice Address - Phone:978-577-1946
Practice Address - Fax:978-692-4716
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2268521364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health