Individual provider · NPI-1

Shirley Gwen Rogerson, MPH,BSN,RN,CDE

Registered Nurse, Diabetes Educator · Lakeland, FL

NPI number1407355217
StatusActive
Last updated in NPPESFeb 7, 2018

Details

NPI
1407355217
Entity type
Individual (NPI-1)
Name
Shirley Gwen Rogerson
Credential
MPH,BSN,RN,CDE
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 7, 2018
Last updated
Feb 7, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WD0400X Registered Nurse, Diabetes Educator9170975FLYes
163WD0400X Registered Nurse, Diabetes EducatorRN9170975FL
163WD0400X Registered Nurse, Diabetes Educator917905FL

Practice location

4710 S Florida Ave
Lakeland, FL 33813-2165

Phone 863-284-3950 · Fax 863-284-3951

Mailing address

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543

Phone 863-284-1604 · Fax 863-687-1412

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