Individual
JENNIE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
504 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
Mailing address
504 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
74588
NM
363LA2100X
Acute Care Nurse Practitioner
74588
NM
Other
Enumeration date
09/29/2023
Last updated
03/04/2024
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