MEDICARE: SELENA MAGDALENA RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1376474874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SELENA MAGDALENA RODRIGUEZ

Provider Business Mailing Address
First Line	:	802 CUSTER AVE
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-0859
Country	:	US
Telephone Number	:	402-841-9088
Fax Number	:

Provider Business Practice Location Address
First Line	:	802 CUSTER AVE
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-0859
Country	:	US
Telephone Number	:	402-841-9088
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ SELENA MAGDALENA RODRIGUEZ ” Practice Location

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