Provider Demographics
NPI:1114474186
Name:RODRIGUEZ, SANDRA ANNE (CNM DNP LNC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ANNE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CNM DNP LNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 S AIRPORT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6651
Mailing Address - Country:US
Mailing Address - Phone:956-647-5529
Mailing Address - Fax:956-647-5617
Practice Address - Street 1:913 S AIRPORT DR
Practice Address - Street 2:SUITE A
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6651
Practice Address - Country:US
Practice Address - Phone:956-647-5529
Practice Address - Fax:956-647-5617
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109884367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife