Provider Demographics
NPI:1164851432
Name:RODRIGUES, AILIN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:AILIN
Middle Name:
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 LAFAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5353
Mailing Address - Country:US
Mailing Address - Phone:978-542-6413
Mailing Address - Fax:978-542-7121
Practice Address - Street 1:352 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5348
Practice Address - Country:US
Practice Address - Phone:978-542-6413
Practice Address - Fax:978-542-7121
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264773163W00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse