Provider Demographics
NPI:1699572677
Name:RODRIGUEZ, NANCY I
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:I
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12406 HIGHWAY 5 STE F
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-7657
Mailing Address - Country:US
Mailing Address - Phone:501-500-0272
Mailing Address - Fax:
Practice Address - Street 1:12406 HIGHWAY 5 STE F
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-7657
Practice Address - Country:US
Practice Address - Phone:501-500-0272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4414246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other