Provider Demographics
NPI:1346512951
Name:RODRIGUEZ, JESSICA RHEA (PA)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RHEA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 2723
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802-2723
Mailing Address - Country:US
Mailing Address - Phone:252-212-3487
Mailing Address - Fax:252-212-3497
Practice Address - Street 1:111 S FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6971
Practice Address - Country:US
Practice Address - Phone:252-446-3333
Practice Address - Fax:252-446-0426
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2014-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC001003295363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant