Provider Demographics
NPI:1699727131
Name:ROGERS, SHERRA (ARNP)
Entity type:Individual
Prefix:MS
First Name:SHERRA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3554
Mailing Address - Country:US
Mailing Address - Phone:812-282-1888
Mailing Address - Fax:812-218-9318
Practice Address - Street 1:510 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3554
Practice Address - Country:US
Practice Address - Phone:812-282-1888
Practice Address - Fax:812-218-9318
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016P363LP0808X
KY3003016363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1487872636OtherARNP NPI GROUP #
000000704589OtherANTHEM #
KY7100155400Medicaid
KYCK2274OtherRR MEDICARE GROUP NUMBER
KYP00931912OtherRR MEDICARE
1063415297OtherPV GROUP MD NPI
KY0500225Medicare PIN
000000704589OtherANTHEM #
KYCK2274OtherRR MEDICARE GROUP NUMBER
KY0500618Medicare PIN
KY00841006Medicare PIN
1487872636OtherARNP NPI GROUP #
1063415297OtherPV GROUP MD NPI
KYP00453Medicare UPIN
KY0501212Medicare PIN