Provider Demographics
NPI:1407288970
Name:RODRIGUEZ, ASHLEY NICOLE
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18436 W CARIBBEAN LN
Mailing Address - Street 2:APT/SUITE
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-7508
Mailing Address - Country:US
Mailing Address - Phone:714-876-7163
Mailing Address - Fax:
Practice Address - Street 1:18436 W CARIBBEAN LN
Practice Address - Street 2:APT/SUITE
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-7508
Practice Address - Country:US
Practice Address - Phone:714-876-7163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker