Provider Demographics
NPI:1649862434
Name:RODRIGUEZ, DAISY (FNP-C)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 E ROOSEVELT CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-4407
Mailing Address - Country:US
Mailing Address - Phone:559-631-7822
Mailing Address - Fax:
Practice Address - Street 1:565 N THOMPSON RD
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:CA
Practice Address - Zip Code:93272-9756
Practice Address - Country:US
Practice Address - Phone:559-752-4147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016585363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner