Individual
JULIE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP, RN
Contact information
Practice address
1201 CANYON CREEK DR, TEMPLE, TX 76502-3299
(254) 410-5102
Mailing address
9002 SANDYFORD CT, KILLEEN, TX 76542-6292
(646) 361-2175
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
583418
NY
163WC1500X
Community Health Registered Nurse
583418
NY
2084P0800X
Psychiatry Physician
589994
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1000559
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
583418
—
NY
Enumeration date
04/25/2007
Last updated
05/30/2024
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