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General NPI Number Information
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NPI Number | 1366313470
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Entity Type | Individual
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Provider Name | SEAN PATRICK RODGERSON II FNP-C
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Gender | Male
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Dates
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Enumeration Date | 09/13/2025
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 3838 N CAMPBELL AVE
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City | TUCSON
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State | AZ
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Zip | 85719-1454
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Country | US
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Telephone | 928-502-9890
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Fax |
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Provider Business Mailing Address
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Address Line | 1474 W 10 S
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6712
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Country | US
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Telephone | 928-502-9890
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F08250329
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License Number State | UT
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