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General NPI Number Information
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NPI Number | 1295974616
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Entity Type | Individual
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Provider Name | JULIA JASKWHICH RODRIGUEZ APRN
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Gender | Female
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 1616 ASHLEY RIVER RD
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City | CHARLESTON
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State | SC
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Zip | 29407-5902
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Country | US
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Telephone | 843-556-9177
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Fax | 843-571-2742
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Provider Business Mailing Address
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Address Line | 1620 ASHLEY RIVER RD BUILDING J
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City | CHARLESTON
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State | SC
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Zip | 29407-5902
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Country | US
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Telephone | 843-556-8177
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Fax | 843-571-2742
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN109735
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4422
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License Number State | SC
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