Provider Demographics
NPI:1780342147
Name:RODRIGUEZ, HALEY LEE (PA-C, CCSH)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:LEE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PA-C, CCSH
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:LEE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, CCSH
Mailing Address - Street 1:19716 W MULBERRY DR
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-5484
Mailing Address - Country:US
Mailing Address - Phone:480-215-8480
Mailing Address - Fax:
Practice Address - Street 1:8330 E HARTFORD DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7205
Practice Address - Country:US
Practice Address - Phone:480-613-4029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8914207RS0012X, 363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant