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NPI Code Detail

MEDICARE: MRS. DOROTHY HELEN RODRIGUEZ ANP-BC

MEDICARE: MRS. DOROTHY HELEN RODRIGUEZ ANP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner4704167051MI
2363LA2200XAdult Health Nurse Practitioner4704167051MI

General Provider Information

NPI Number : 1043261985
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DOROTHY HELEN RODRIGUEZ ANP-BC
Provider Business Mailing Address
First Line : 3145 DIXIE HWY
Second Line :
City : WATERFORD
State : MI
Zip : 48328-1602
Country : US
Telephone Number : 248-338-5000
Fax Number : 248-338-5584
Provider Business Practice Location Address
First Line : 50 N PERRY ST
Second Line :
City : PONTIAC
State : MI
Zip : 48342-2217
Country : US
Telephone Number : 248-338-5210
Fax Number : 248-338-5584
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 01/06/2019

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