Provider Demographics
NPI:1376728188
Name:RODRIGUEZ, ANNA MARIE (MS, RDN, LD, DIPACLM)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, RDN, LD, DIPACLM
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:JOAS-ROCKHOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:3224 90TH ST
Mailing Address - Street 2:
Mailing Address - City:STURTEVANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-2719
Mailing Address - Country:US
Mailing Address - Phone:830-377-2559
Mailing Address - Fax:830-377-2559
Practice Address - Street 1:3224 90TH ST
Practice Address - Street 2:
Practice Address - City:STURTEVANT
Practice Address - State:WI
Practice Address - Zip Code:53177-2719
Practice Address - Country:US
Practice Address - Phone:830-377-2559
Practice Address - Fax:830-377-2559
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05346133V00000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered