Provider Demographics
NPI:1497351076
Name:ROGERS, ANGELA RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:RENEE
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 1:5656 BEE CAVES RD STE C101
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5281
Mailing Address - Country:US
Mailing Address - Phone:512-416-9333
Mailing Address - Fax:
Practice Address - Street 1:5656 BEE CAVES RD
Practice Address - Street 2:BUILDING C SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-416-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021161363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care