MEDICARE: DR. KAITLIN RAYE RODRIGUEZ DN

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
1	172P00000X	Naprapath

General Provider Information

NPI Number	:	1689318552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAITLIN RAYE RODRIGUEZ DN

Provider Business Mailing Address
First Line	:	2006 BOTULPH RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-5730
Country	:	US
Telephone Number	:	505-424-8990
Fax Number	:	505-424-6377

Provider Business Practice Location Address
First Line	:	2006 BOTULPH RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-5730
Country	:	US
Telephone Number	:	505-424-8990
Fax Number	:	505-424-6377

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	04/26/2022

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