Provider Demographics
NPI:1912910472
Name:ROGERS, ELIZABETH BURNETT (PMH-NP, CNS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BURNETT
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PMH-NP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11022 S 51ST ST STE 250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4319
Mailing Address - Country:US
Mailing Address - Phone:480-779-9900
Mailing Address - Fax:602-429-8445
Practice Address - Street 1:11022 S 51ST ST STE 250
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4319
Practice Address - Country:US
Practice Address - Phone:480-779-9900
Practice Address - Fax:602-429-8445
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4193363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ650176Medicaid
AZZ181629Medicare PIN