Healthcare Provider Details

I. General information

NPI: 1164851432
Provider Name (Legal Business Name): AILIN RODRIGUES CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WALNUT ST STE F
SAUGUS MA
01906-1158
US

IV. Provider business mailing address

200 WALNUT ST STE F
SAUGUS MA
01906-1158
US

V. Phone/Fax

Practice location:
  • Phone: 339-243-8429
  • Fax:
Mailing address:
  • Phone: 339-243-8429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2264773
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2264773
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: