Provider Demographics
NPI:1558095570
Name:RODRIGUEZ, AMANDA EILEEN (RD)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:EILEEN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19216 E HOLLOW CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3423
Mailing Address - Country:US
Mailing Address - Phone:303-888-4652
Mailing Address - Fax:
Practice Address - Street 1:19216 E HOLLOW CREEK LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3423
Practice Address - Country:US
Practice Address - Phone:303-888-4652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered