Provider Demographics
NPI:1720544612
Name:RODRIGUES, NANCY A (RN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RYAN CHELSEA CLINTON CLINIC
Mailing Address - Street 2:645 10TH AVE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-316-8336
Mailing Address - Fax:212-866-8336
Practice Address - Street 1:RYAN CHELSEA CLINTON CLINIC
Practice Address - Street 2:645 10TH AVE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-1003
Practice Address - Country:US
Practice Address - Phone:212-316-8336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600274163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY600274OtherNY STATE BOARD OF NURSING