Doctor Name: | MONICA A. RODRIGUEZ |
NPI Number: | 1023429552 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | CNP-02411 |
Business Practice Address: | 93 Little Glorietta Cloudcroft, NM - 883170013 |
Business Phone Number: | 5756823309 |
Business Fax Number: | |
Mailing Address: | Po Box 834, 26 Hummingbird Ln. HIGH ROLLS MOUNTAIN PARK |
State: | NM |
Postal Code: | 883250834 |
Phone Number: | 5756825421 |
Fax Number: | |
NPI Enumeration Date: | 05/19/2014 |
NPI Last Update Date: | 05/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP-02411 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |