Provider Demographics
NPI:1912622150
Name:RODRIGUEZ, JESUS (FNP)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 WESTWIND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1743
Mailing Address - Country:US
Mailing Address - Phone:915-974-2200
Mailing Address - Fax:
Practice Address - Street 1:7100 WESTWIND DR STE 300
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1743
Practice Address - Country:US
Practice Address - Phone:915-974-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1086284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily