Provider Demographics
NPI:1669073599
Name:RODRIGUEZ, JULIE SUZANNE (APRN, FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:SUZANNE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9902
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79708-9902
Mailing Address - Country:US
Mailing Address - Phone:432-934-8509
Mailing Address - Fax:432-684-4341
Practice Address - Street 1:421 W WADLEY AVE STE B
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-5368
Practice Address - Country:US
Practice Address - Phone:432-644-4327
Practice Address - Fax:432-684-4341
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine