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NPI Code Detail

MEDICARE: REBECCA J RODRIGUEZ

MEDICARE: REBECCA J RODRIGUEZ
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 Practitioner16358-33WI

General Provider Information

NPI Number : 1811245475
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA J RODRIGUEZ
Provider Business Mailing Address
First Line : 3517 29TH ST
Second Line :
City : KENOSHA
State : WI
Zip : 53144-1663
Country : US
Telephone Number : 262-705-6846
Fax Number :
Provider Business Practice Location Address
First Line : 4006 WASHINGTON RD
Second Line :
City : KENOSHA
State : WI
Zip : 53144-4819
Country : US
Telephone Number : 262-656-0044
Fax Number : 262-925-3255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2012
Last Update Date : 09/24/2025

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Directions to “ REBECCA J RODRIGUEZ ” Practice Location

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