Provider Demographics
NPI:1477063758
Name:ROGERS, JESSICA (CPNP-AC, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CPNP-AC, PMHNP-BC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:JEAN
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JESSICA JEAN SMITH
Mailing Address - Street 1:4270 CLIFFORD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3111
Mailing Address - Country:US
Mailing Address - Phone:513-477-8181
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE # 2010
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4415
Practice Address - Fax:513-636-7805
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.402716163W00000X
OHAPRN.CNP.021514363LP0200X, 363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health