Individual
PAUL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
105 W GRIGGS AVE, LAS CRUCES, NM 88001-1235
(575) 647-2800
(575) 647-2898
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L16882
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92487211
—
NM
Enumeration date
01/31/2018
Last updated
01/21/2019
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