Provider Demographics
NPI:1124093687
Name:ROGERS, ROBIN C (MSN,FNP-BC,ANP,RN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:C
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MSN,FNP-BC,ANP,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 SECOND ST S
Mailing Address - Street 2:
Mailing Address - City:FOLKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:31537-8447
Mailing Address - Country:US
Mailing Address - Phone:912-496-0041
Mailing Address - Fax:912-496-0053
Practice Address - Street 1:3435 SECOND ST S
Practice Address - Street 2:
Practice Address - City:FOLKSTON
Practice Address - State:GA
Practice Address - Zip Code:31537-8447
Practice Address - Country:US
Practice Address - Phone:912-496-0041
Practice Address - Fax:912-496-0053
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9240425363L00000X
GARN075846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003132940BMedicaid
GA003132940CMedicaid
GA003132940DMedicaid
GA003132940EMedicaid
GA003132940EMedicaid