Provider Demographics
NPI:1356704928
Name:RODRIGUEZ, KARIS ASHLEY (APRN CNP)
Entity type:Individual
Prefix:
First Name:KARIS
Middle Name:ASHLEY
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 MCDOUGAL DR
Mailing Address - Street 2:
Mailing Address - City:HOLDENVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74848-2899
Mailing Address - Country:US
Mailing Address - Phone:405-379-4200
Mailing Address - Fax:405-379-4252
Practice Address - Street 1:100 MCDOUGAL DR
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-2899
Practice Address - Country:US
Practice Address - Phone:405-379-4200
Practice Address - Fax:405-379-4252
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK106928363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily