Provider Demographics
NPI:1134183155
Name:RODGERS, TERI CAROL (DNP, PMHNP-C, FNP-C)
Entity type:Individual
Prefix:DR
First Name:TERI
Middle Name:CAROL
Last Name:RODGERS
Suffix:
Gender:F
Credentials:DNP, PMHNP-C, FNP-C
Other - Prefix:DR
Other - First Name:TERI
Other - Middle Name:STEWART
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, PMHNP-C, FNP-C
Mailing Address - Street 1:2509 STEEPLECHASE RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-0315
Mailing Address - Country:US
Mailing Address - Phone:047-718-4755
Mailing Address - Fax:
Practice Address - Street 1:310 MOCKSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3328
Practice Address - Country:US
Practice Address - Phone:704-762-9630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201161363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113008Medicaid
NC500028327OtherRAILROAD MEDICARE
NC7000313Medicaid
NC7000313Medicaid