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General NPI Number Information
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NPI Number | 1346902418
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Entity Type | Individual
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Provider Name | MARICE K RODRIGUEZ APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 3200 CANYON LAKE DR
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City | RAPID CITY
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State | SD
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Zip | 57702-8114
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Country | US
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Telephone | 605-355-2500
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Fax | 605-355-2517
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Provider Business Mailing Address
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Address Line | 4500 N LEWIS AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57104-7111
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Country | US
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Telephone | 605-322-6368
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Fax |
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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 | R46351
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License Number State | ND
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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 | 9991
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CP002575
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License Number State | SD
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