Provider Demographics
NPI:1104485630
Name:ROGERS, JENNIFER LUCILLE (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LUCILLE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10739 S US 127
Mailing Address - Street 2:
Mailing Address - City:DUNNVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42528-6037
Mailing Address - Country:US
Mailing Address - Phone:606-787-3405
Mailing Address - Fax:606-787-3404
Practice Address - Street 1:10739 S US 127
Practice Address - Street 2:
Practice Address - City:DUNNVILLE
Practice Address - State:KY
Practice Address - Zip Code:42528-6037
Practice Address - Country:US
Practice Address - Phone:606-787-3405
Practice Address - Fax:606-787-3404
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily