Individual
JACQUELINE C RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
507 PRINCETON DR SE, ALBUQUERQUE, NM 87106-2803
(318) 347-3041
Mailing address
507 PRINCETON DR SE, ALBUQUERQUE, NM 87106-2803
(318) 347-3041
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
54967
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54967
—
NM
Enumeration date
08/28/2019
Last updated
08/28/2019
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