Healthcare Provider Details

I. General information

NPI: 1205503174
Provider Name (Legal Business Name): AMANDA ANIELKA RODRIGUEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 N ARNOULT RD
METAIRIE LA
70002-4713
US

IV. Provider business mailing address

1211 KABEL DR
NEW ORLEANS LA
70131-3519
US

V. Phone/Fax

Practice location:
  • Phone: 504-267-4659
  • Fax: 504-301-0704
Mailing address:
  • Phone: 504-352-4711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number221900
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: