Healthcare Provider Details

I. General information

NPI: 1164301883
Provider Name (Legal Business Name): AMBER LYNN RODRIGUEZ CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 W MEETING ST BLDG 4
LANCASTER SC
29720-6251
US

IV. Provider business mailing address

PO BOX 23321
NEW YORK NY
10087-4321
US

V. Phone/Fax

Practice location:
  • Phone: 803-285-5900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAPN.31747RX
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: