Individual
JOHARY RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-3937
(208) 642-9598
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-3937
(208) 642-9598
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
9325608
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
56903
ID
Other
Enumeration date
10/08/2015
Last updated
07/22/2025
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