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General NPI Number Information
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NPI Number | 1740451129
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Entity Type | Individual
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Provider Name | DORIS JEAN RODRIGUEZ PHD, RN, C-PNP/PC
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Gender | Female
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 1015 DONALD LEE HOLLOWELL PKWY NW
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City | ATLANTA
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State | GA
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Zip | 30318-6653
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Country | US
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Telephone | 404-523-6571
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Fax |
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Provider Business Mailing Address
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Address Line | 105 PUTMANS HEAD
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1238
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Country | US
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Telephone | 770-843-8787
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN123156
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License Number State | GA
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