Provider Demographics
NPI:1316678857
Name:RODRIGUEZ, BARBARA ANN (WHNP-BC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 S PETUNIA WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4318
Mailing Address - Country:US
Mailing Address - Phone:801-878-8888
Mailing Address - Fax:801-878-8890
Practice Address - Street 1:10150 S PETUNIA WAY
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-4318
Practice Address - Country:US
Practice Address - Phone:801-878-8888
Practice Address - Fax:801-878-8890
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT317360-4405363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health