Individual
MRS. MILDRED RODRIGUEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, IBCLC
Contact information
Practice address
11050 MOUNT BELVEDERE BLVD, USA MEDDAC/CREDENTIALS, FORT DRUM, NY 13602-5438
(315) 772-4025
(315) 772-9498
Mailing address
11050 MOUNT BELVEDERE BLVD, USA MEDDAC ATTN: CREDENTIALS, FORT DRUM, NY, FORT DRUM, NY 13602-5438
(315) 772-4025
(315) 772-9498
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
478635-1
NY
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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