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General NPI Number Information
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NPI Number | 1316307309
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Entity Type | Individual
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Provider Name | STEPHANIE MICHELLE RODRIQUEZ FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 1 JARRET WHITE RD
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City | HONOLULU
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State | HI
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Zip | 95859
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Country | US
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Telephone | 808-433-7076
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Fax |
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Provider Business Mailing Address
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Address Line | 598 W CHATFIELD ST
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City | VAIL
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State | AZ
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Zip | 85641-6755
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Country | US
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Telephone | 602-509-5184
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Fax | 520-533-5309
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 99520
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN154919
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License Number State | AZ
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