Provider Demographics
NPI:1306639034
Name:RODRIGUEZ, SARA MASSIEL
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MASSIEL
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 N LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-3554
Mailing Address - Country:US
Mailing Address - Phone:402-620-8354
Mailing Address - Fax:
Practice Address - Street 1:1349 N LOGAN ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3554
Practice Address - Country:US
Practice Address - Phone:402-620-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker