Provider Demographics
NPI:1588137491
Name:ROGERS, TIARHONDA DELONCIA (FNP)
Entity type:Individual
Prefix:MS
First Name:TIARHONDA
Middle Name:DELONCIA
Last Name:ROGERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 TES DR
Mailing Address - Street 2:
Mailing Address - City:CHOUDRANT
Mailing Address - State:LA
Mailing Address - Zip Code:71227-3197
Mailing Address - Country:US
Mailing Address - Phone:318-497-1700
Mailing Address - Fax:
Practice Address - Street 1:134 TES DR
Practice Address - Street 2:
Practice Address - City:CHOUDRANT
Practice Address - State:LA
Practice Address - Zip Code:71227-3197
Practice Address - Country:US
Practice Address - Phone:318-497-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202042363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner