Provider Demographics
NPI:1881443646
Name:RODRIGUEZ, CORINA DEBBIE (RN)
Entity type:Individual
Prefix:
First Name:CORINA
Middle Name:DEBBIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 PLEASANT KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2804
Mailing Address - Country:US
Mailing Address - Phone:956-289-9457
Mailing Address - Fax:
Practice Address - Street 1:1306 PLEASANT KNOLL CT
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2804
Practice Address - Country:US
Practice Address - Phone:956-289-9457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041430293163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse