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General NPI Number Information
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NPI Number | 1689315012
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Entity Type | Individual
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Provider Name | MARI C RODRIGUEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 483 W SEED FARM RD
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City | SACATON
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State | AZ
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Zip | 85147-5000
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Country | US
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Telephone | 602-528-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 22038 E CAMACHO RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-8295
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Country | US
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Telephone | 480-268-6350
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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 | RNP273484
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License Number State | AZ
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