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General NPI Number Information
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NPI Number | 1700423662
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 2940 N MCCORD RD
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City | TOLEDO
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State | OH
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Zip | 43615-1753
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Country | US
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Telephone | 419-842-3000
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Fax | 419-842-3047
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Provider Business Mailing Address
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Address Line | 953 MAPLE ST
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City | PERRYSBURG
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State | OH
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Zip | 43551-2425
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Country | US
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Telephone | 419-680-5925
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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 | 4704358517
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.026048
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License Number State | OH
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