Provider Demographics
NPI:1427755032
Name:RODRIGUEZ, DANIELLE LYNETTE (CNM, APRN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYNETTE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:LYNETTE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2758 LAKEHILLS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1743
Mailing Address - Country:US
Mailing Address - Phone:254-449-5287
Mailing Address - Fax:
Practice Address - Street 1:11212 STATE HIGHWAY 151 STE 150
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4505
Practice Address - Country:US
Practice Address - Phone:210-233-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110788367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife