Healthcare Provider Details

I. General information

NPI: 1861669061
Provider Name (Legal Business Name): ERIN ELIZABETH RODRIGUEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN ELIZABETH VERCHER RN

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 SAILMAKER LN
RICHMOND HILL GA
31324-1410
US

IV. Provider business mailing address

175 SAILMAKER LN
RICHMOND HILL GA
31324-1410
US

V. Phone/Fax

Practice location:
  • Phone: 760-514-6459
  • Fax:
Mailing address:
  • Phone: 760-514-6459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number147670-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: