Roderick, Addie

Roderick, Addie is an individual health care provider with primary practice located at 105 S Delaware Dr Ste 2 , Apache Junction AZ 85120-6512. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Roderick, Addie can be contacted via phone (480) 646-1001.

Contact Information

Primary practice address
105 S Delaware Dr Ste 2 Apache Junction AZ 85120-6512
Phone: (480) 646-1001
Fax: (480) 646-1002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APN6179 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP3930 Arizona

Profile Details

NPI number 1447206529
LBN Legal business name Roderick, Addie
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447206529 NPPES
Arizona Other AP3930 LICENSE
Arizona MEDICAID 78013760 LICENSE
Arizona Other 4087938 LICENSE
Arizona MEDICAID 653785 LICENSE

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