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General NPI Number Information
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NPI Number | 1992520415
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Entity Type | Individual
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Provider Name | MELISSA RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2402 IMPERIAL BUSINESS PARK DR
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City | IMPERIAL
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State | CA
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Zip | 92251-4004
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Country | US
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Telephone | 760-355-5248
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Fax |
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Provider Business Mailing Address
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Address Line | 7559 E 42ND PL
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City | YUMA
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State | AZ
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Zip | 85365-8458
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Country | US
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Telephone | 928-503-7268
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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 | NP95032410
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License Number State | CA
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