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General NPI Number Information
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NPI Number | 1619660875
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Entity Type | Individual
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Provider Name | ALISSANDRA MARIE RODRIGUEZ NP
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Gender | Female
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 3110 10TH ST N APT 106
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City | ARLINGTON
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State | VA
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Zip | 22201-2072
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Country | US
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Telephone | 703-589-9665
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Fax |
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Provider Business Mailing Address
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Address Line | 6129 LEESBURG PIKE APT 1217
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City | FALLS CHURCH
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State | VA
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Zip | 22041-2160
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Country | US
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Telephone | 540-325-0600
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024187050
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License Number State | VA
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