Individual
TARA JAYNE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12125 SW 17TH ST, YUKON, OK 73099-4564
(405) 965-6470
Mailing address
12125 SW 17TH ST, YUKON, OK 73099-4564
(405) 965-6470
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R0110289
OK
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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