1477639482 NPI number — MONICA RENA ROGERS FNP-C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477639482 NPI number — MONICA RENA ROGERS FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROGERS
Provider First Name:
MONICA
Provider Middle Name:
RENA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PERKINS
Provider Other First Name:
MONICA
Provider Other Middle Name:
RENE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477639482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
155 CIMARRON PARK LOOP
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
BUDA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78610-2847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-295-9300
Provider Business Mailing Address Fax Number:
512-295-7300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10925 SIGNAL HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78737-9214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-619-9045
Provider Business Practice Location Address Fax Number:
512-295-7300
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  661310 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 661310 . This is a "BOARD OF NURSE EXAMINERS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: F0606259 . This is a "AANP-NURSE PRACTIONER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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