Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | A01761 ANP | AR |
NPI | 1083705388 |
---|---|
Provider Name | Ms. Ernice Lashette Rogers |
First Address | Pine Bluff, AR 71603-3933 |
Second Address | Pine Bluff, AR 71603-3933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 21/02/2013 |