Individual
DEBRA K RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Mailing address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009390
PHYS PLUS PROV #
WI
01
—
391023846
COMM INS PROV #
WI
05
—
43829200
—
WI
01
—
500010902
RAILROAD MEDICARE PROV #
WI
01
—
70
DEANCARE PROV #
WI
Enumeration date
12/15/2005
Last updated
01/26/2017
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