Provider Demographics
NPI:1801160791
Name:RODRIGUEZ, AMBER E (NP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:E
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:E
Other - Last Name:STEADMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5100 SPRINGFIELD ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1261
Mailing Address - Country:US
Mailing Address - Phone:937-259-9900
Mailing Address - Fax:937-259-9999
Practice Address - Street 1:30 E APPLE ST
Practice Address - Street 2:SUITE 5253
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2939
Practice Address - Country:US
Practice Address - Phone:937-208-2552
Practice Address - Fax:937-208-6154
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-340458-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN-340458OtherREGISTERED NURSE