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General NPI Number Information
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NPI Number | 1730184268
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Entity Type | Individual
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Provider Name | MICHELLE LYNN RODRIGUEZ GONZALEZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 4301 W MARKHAM ST # 783
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-686-8000
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Fax | 501-526-5148
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Provider Business Mailing Address
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Address Line | 22 S GREENE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1544
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Country | US
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Telephone | 410-328-5492
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AC000728
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R168263
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R168263
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C003274
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License Number State | AR
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Taxonomy #5
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U-1475
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License Number State | MD
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