Provider Demographics
NPI:1326182221
Name:RODRIGUEZ, RINA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RINA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CCO 1-36 IN
Mailing Address - Street 2:CMR 453 BOX 2366
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09074
Mailing Address - Country:US
Mailing Address - Phone:0170-367-2951
Mailing Address - Fax:
Practice Address - Street 1:USAHC-FRIEDBERG
Practice Address - Street 2:CMR 453
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09074
Practice Address - Country:US
Practice Address - Phone:0603-181-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00046250164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse