Individual
MRS. LEE E RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
69300 NEE RD, QUAPAW, OK 74363-2134
(918) 919-6114
(918) 919-6115
Mailing address
4500 ROSE CIR, JOPLIN, MO 64804-9063
(417) 529-5047
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
083099
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424768414
—
MO
Enumeration date
05/22/2006
Last updated
11/16/2017
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