Penny Lou Rogers, FNP
Individual provider Active NPI Family Nurse Practitioner · Kincheloe, MI
NPI 1962666008 · NPPES record last updated Jul 17, 2008
Key facts
- NPI
- 1962666008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704114228 (MI)
- Practice address
- 4533 W Industrial Park Dr
Kincheloe, MI 49786-0001 - Phone
- (906) 495-5661
- NPI assigned
- Jul 17, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704114228 | MI | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704114228 | MI | Yes |
Addresses
Primary practice location
4533 W Industrial Park Dr
Kincheloe, MI 49786-0001
Mailing address
9586 S Mackinac TRL
Sault Sainte Marie, MI 49783-9267
Phone (906) 632-7138
Other providers in Kincheloe, MI
- Mymichigan Medical Center Sault
- Northern EMS Authority
- R. Kent Owen
- Katie Peabody
- Maddison Picotte
- Sault Tribe of Chippewa Indians
- Jill Irene Sayer
- Laindra Schuler
- Jonathan Sommers
- Timothy J Stallman
All providers in Kincheloe, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.