Alicia Yvonne Bryant-Rodgers, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00362400 Issued in NJ

Practice address

30 Lake Center Executive Park
Suite 100
Marlton, NJ 08053

Phone

(856) 452-9901

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1992929483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LAKE CENTER EXEUTIVE PARK",
            "address_2": "SUITE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LAKE CENTER EXECUTIVE PARK",
            "address_2": "SUITE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-452-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT-RODGERS",
        "first_name": "ALICIA",
        "middle_name": "YVONNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00362400",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP007399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Brown, CMA
• Stacie Brown
• Taylor Brubaker
• Kim Lisa Brunnet, APRN
• Bryan C Russell (Elite Spine and Sport Center)
• BSH Health NJ, P.C.
• Stefani Buck-Bivens, MS, CCC-SLP
• Lidiya Bukenova
• Katie Bullock, CD, CBC
• Joseph A Buonadonna Sr., PHD

• Adult Health Nurse Practitioner in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.