Doctor Name: | MRS. DOROTHY HELEN RODRIGUEZ |
NPI Number: | 1043261985 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP-BC |
License Number: | 4704167051 |
Business Practice Address: | 501 N Cass Lake Rd Room 213 Waterford, MI - 483282307 |
Business Phone Number: | 2486744876 |
Business Fax Number: | 2486821089 |
Mailing Address: | 46 N Saginaw St, PONTIAC |
State: | MI |
Postal Code: | 483422155 |
Phone Number: | 2483226747 |
Fax Number: | 2483225787 |
NPI Enumeration Date: | 05/15/2006 |
NPI Last Update Date: | 08/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 4704167051 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |