Provider Demographics
NPI:1477257202
Name:RODRIGUEZ, NAKIA N (CRNP)
Entity Type:Individual
Prefix:
First Name:NAKIA
Middle Name:N
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 OLD YORK RD STE 301
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-4626
Mailing Address - Country:US
Mailing Address - Phone:215-254-6000
Mailing Address - Fax:
Practice Address - Street 1:1021 OLD YORK RD STE 301
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-4626
Practice Address - Country:US
Practice Address - Phone:215-254-6000
Practice Address - Fax:215-754-1705
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027201363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health