Provider Demographics
NPI:1871935593
Name:RODGERS, BETSY (FNP)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:NY
Mailing Address - Zip Code:12197-1900
Mailing Address - Country:US
Mailing Address - Phone:607-847-6050
Mailing Address - Fax:607-847-7519
Practice Address - Street 1:198 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:NY
Practice Address - Zip Code:12197-1900
Practice Address - Country:US
Practice Address - Phone:607-397-1013
Practice Address - Fax:607-397-1014
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF320086-1363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health