Individual
MR. NICHOLAS JOHN CASEY RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
1001 S HORSEBARN RD, ROGERS, AR 72758-8184
(479) 273-7700
(479) 273-7753
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(479) 273-7700
(479) 273-7753
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2020018088
MO
363LA2100X
Acute Care Nurse Practitioner
ATP-000747
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
394391ZMTF
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
AR
Enumeration date
01/22/2015
Last updated
03/16/2026
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