Provider Demographics
NPI:1609838820
Name:ROGERS, LAURIE ANN
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:ANN
Other - Last Name:ESPINOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 STILES RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4881
Mailing Address - Country:US
Mailing Address - Phone:603-685-6977
Mailing Address - Fax:603-685-6975
Practice Address - Street 1:7 STILES RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4881
Practice Address - Country:US
Practice Address - Phone:603-685-6977
Practice Address - Fax:603-685-6975
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9231324363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30346019Medicaid
MA0714348Medicaid
NH40Y011748NH01OtherANTHEM
NH30346019Medicaid
NH000138601Medicare PIN
NH40Y011748NH01OtherANTHEM