Provider Demographics
NPI:1801121165
Name:ROGERS, JESSI MARIE (MPAS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:JESSI
Middle Name:MARIE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:303 E 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:TARENTUM
Mailing Address - State:PA
Mailing Address - Zip Code:15084-1003
Mailing Address - Country:US
Mailing Address - Phone:724-224-2770
Mailing Address - Fax:724-224-1077
Practice Address - Street 1:303 E 10TH AVE
Practice Address - Street 2:
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084-1003
Practice Address - Country:US
Practice Address - Phone:724-224-2770
Practice Address - Fax:724-224-1077
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY013583363AM0700X
PAOA002571363AM0700X
PAMA054707363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical