Kimberly Rodriguez
Nurse Practitioner in Phoenix, AZ. Individual provider (NPI-1).
NPI number1134059611
StatusActive
Last updated in NPPESJul 21, 2026
Details
- NPI
- 1134059611
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kimberly Rodriguez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 19, 2026
- Certification date
- Jul 21, 2026
- Last updated
- Jul 21, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 241963 | AZ | Yes |
Practice location
1209 S 1st AvePhoenix, AZ 85003-2692
Phone 602-258-6797
Mailing address
305 W Mesquite StChandler, AZ 85225-2663
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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