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General NPI Number Information
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NPI Number | 1669073599
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Entity Type | Individual
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Provider Name | JULIE SUZANNE RODRIGUEZ APRN, FNP
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Gender | Female
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 421 W WADLEY AVE STE B
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City | MIDLAND
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State | TX
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Zip | 79705-5368
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Country | US
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Telephone | 432-644-4327
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Fax | 432-684-4341
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Provider Business Mailing Address
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Address Line | PO BOX 9902
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City | MIDLAND
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State | TX
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Zip | 79708-9902
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Country | US
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Telephone | 432-934-8509
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Fax | 432-684-4341
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1018579
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License Number State | TX
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