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General NPI Number Information
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NPI Number | 1073060950
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Entity Type | Individual
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Provider Name | KRISTEN RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | 5800 PARK CENTER CT STE C
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City | TOLEDO
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State | OH
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Zip | 43615-0710
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Country | US
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Telephone | 419-724-8368
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SEAGATE
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City | TOLEDO
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State | OH
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Zip | 43604-1558
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Country | US
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Telephone | 567-585-1969
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Fax | 419-824-7359
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRNCNP019700
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License Number State | OH
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