Provider Demographics
NPI:1821352410
Name:RODGERS HERINGTON, DEBRA A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:A
Last Name:RODGERS HERINGTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 E CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3230
Mailing Address - Country:US
Mailing Address - Phone:602-277-1727
Mailing Address - Fax:
Practice Address - Street 1:2355 W CHANDLER BLVD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6199
Practice Address - Country:US
Practice Address - Phone:480-792-7777
Practice Address - Fax:480-792-7282
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN000099605163W00000X
AZAP4504207Q00000X, 363LF0000X
AZF0412113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine