Provider Demographics
NPI:1255965190
Name:ROGERSON, ANNE MARIE (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:ROGERSON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 ISLAND WAY
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:ME
Mailing Address - Zip Code:04419-3154
Mailing Address - Country:US
Mailing Address - Phone:207-944-6167
Mailing Address - Fax:
Practice Address - Street 1:305 COMMERCIAL ST STE 103
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-5625
Practice Address - Country:US
Practice Address - Phone:207-808-1384
Practice Address - Fax:207-221-1710
Is Sole Proprietor?:No
Enumeration Date:2020-03-01
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN38531163WP0808X
MECNP201232363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health