Provider Demographics
NPI:1992160329
Name:PATRICIA RODRIGUEZ, FNP-C & ASSOCIATES
Entity type:Organization
Organization Name:PATRICIA RODRIGUEZ, FNP-C & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:928-318-9600
Mailing Address - Street 1:PO BOX 26253
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-1357
Mailing Address - Country:US
Mailing Address - Phone:928-919-9729
Mailing Address - Fax:928-329-6204
Practice Address - Street 1:1950 JUAN SANCHEZ BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:SAN LUIS
Practice Address - State:AZ
Practice Address - Zip Code:85349-6805
Practice Address - Country:US
Practice Address - Phone:928-550-5641
Practice Address - Fax:928-550-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN075667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty