Provider Demographics
NPI:1649959693
Name:ROGERS, ERIK (RN)
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:
Last Name:ROGERS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 S GATESHEAD DR
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-6081
Mailing Address - Country:US
Mailing Address - Phone:801-824-7213
Mailing Address - Fax:
Practice Address - Street 1:45 E STATE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2344
Practice Address - Country:US
Practice Address - Phone:801-824-7213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5182375-3102163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool