Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 517297 | CA |
Y | 363L00000X | Nurse Practitioner | 9964 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 517297 | CA |
NPI | 1003988106 |
---|---|
Provider Name | Barbara Rogers |
First Address | Fresno, CA 93720 |
Second Address | Fresno, CA 93720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 18/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P18791 | (02) | CA |