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NPI Code Detail

MEDICARE: KRISTY LEE RODRIGUE BSN, FNP-C

MEDICARE: KRISTY LEE RODRIGUE BSN, FNP-C
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
1363LF0000XFamily Nurse Practitioner245591LA

General Provider Information

NPI Number : 1336096981
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTY LEE RODRIGUE BSN, FNP-C
Provider Business Mailing Address
First Line : 4055 VALLEY VIEW LN STE 400
Second Line :
City : DALLAS
State : TX
Zip : 75244-5071
Country : US
Telephone Number : 808-600-1855
Fax Number :
Provider Business Practice Location Address
First Line : 4055 VALLEY VIEW LN STE 400
Second Line :
City : DALLAS
State : TX
Zip : 75244-5071
Country : US
Telephone Number : 808-600-1855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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