Provider Demographics
NPI:1154091965
Name:RODRIGUEZ, MAGDELENE MAE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MAGDELENE
Middle Name:MAE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-8530
Mailing Address - Fax:956-362-8535
Practice Address - Street 1:2108 S M ST STE 4
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1556
Practice Address - Country:US
Practice Address - Phone:956-362-8530
Practice Address - Fax:956-362-8535
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1023726363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily