Provider Demographics
NPI:1518123868
Name:ROGERS, SHARON LYNN (APN)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LYNN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7648 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-8912
Mailing Address - Country:US
Mailing Address - Phone:870-512-7833
Mailing Address - Fax:870-512-7715
Practice Address - Street 1:1200 MCLAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3534
Practice Address - Country:US
Practice Address - Phone:870-523-9852
Practice Address - Fax:870-523-3583
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARS02231 CNS364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health