Provider Demographics
NPI:1821689720
Name:ROGERS, DANEISHA LATRELL (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:DANEISHA
Middle Name:LATRELL
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:DANEISHA
Other - Middle Name:LATRELL
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:PO BOX 4715
Mailing Address - Street 2:
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-4715
Mailing Address - Country:US
Mailing Address - Phone:229-309-9079
Mailing Address - Fax:
Practice Address - Street 1:283 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:GA
Practice Address - Zip Code:39823-3455
Practice Address - Country:US
Practice Address - Phone:292-261-9884
Practice Address - Fax:229-261-9895
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN243862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily