Provider Demographics
NPI:1902075666
Name:ROGERS, BOBBIE HARRIS (FNP-C)
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:HARRIS
Last Name:ROGERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:HARRIS
Other - Last Name:SASIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:5846 S FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-3237
Mailing Address - Country:US
Mailing Address - Phone:239-961-9717
Mailing Address - Fax:954-306-6875
Practice Address - Street 1:1524 KINGWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3042
Practice Address - Country:US
Practice Address - Phone:281-247-7289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV851408363LF0000X
NM69849363LF0000X
FLTPAN206363LF0000X
TX683412363LF0000X
FL11020819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1902075666Medicaid
TX1902075666Medicaid
GA853429435OtherHARRISROGERS HOME HEALTH AND REHABILITATION
GA853429435OtherHARRISROGERS HOME HEALTH AND REHABILITATION