Healthcare Provider Details

I. General information

NPI: 1952721920
Provider Name (Legal Business Name): ISABEL RODRIGUEZ APRN; FPMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6090 SURETY DR STE 304
EL PASO TX
79905-2056
US

IV. Provider business mailing address

1600 MONTANA AVE
EL PASO TX
79902-5622
US

V. Phone/Fax

Practice location:
  • Phone: 915-245-5150
  • Fax: 915-351-4708
Mailing address:
  • Phone: 915-887-3410
  • Fax: 915-351-4708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number852367
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1105342
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: