MEDICARE: KASANDRA GARCIA RODRIGUEZ NP

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	363LA2100X	Acute Care Nurse Practitioner	230894	AZ

General Provider Information

NPI Number	:	1902454655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASANDRA GARCIA RODRIGUEZ NP

Provider Business Mailing Address
First Line	:	5431 N ORACLE RD STE 104A
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-0012
Country	:	US
Telephone Number	:	520-314-0910
Fax Number	:

Provider Business Practice Location Address
First Line	:	5431 N ORACLE RD STE 104A
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-0012
Country	:	US
Telephone Number	:	520-314-0910
Fax Number	:

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

Provider Enumeration Date	:	08/27/2019
Last Update Date	:	07/07/2023

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