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General NPI Number Information
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NPI Number | 1912590076
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Entity Type | Individual
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Provider Name | AMANDA RAE RODRIGUEZ APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1110 S DOBSON RD
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City | CHANDLER
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State | AZ
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Zip | 85286-6163
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Country | US
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Telephone | 480-855-3229
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Fax |
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Provider Business Mailing Address
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Address Line | 287 W BUENA VISTA DR
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City | TEMPE
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State | AZ
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Zip | 85284-5270
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Country | US
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Telephone | 602-690-2713
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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 | 252669
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License Number State | AZ
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