Provider Demographics
NPI:1356472096
Name:RODRIGUEZ, DENISE (APN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 NEW RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1537
Mailing Address - Country:US
Mailing Address - Phone:800-461-8262
Mailing Address - Fax:302-663-5386
Practice Address - Street 1:1291 SHADY CREEK LN
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4480
Practice Address - Country:US
Practice Address - Phone:609-922-4076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00219200363LA2200X
NJNJ25ME027901367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife