ADDIE RODERICK FNP-BC NPI 1447206529

NPI Information

NPI: 1447206529
Provider Name: ADDIE RODERICK, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
105 S DELAWARE DR STE 2
APACHE JUNCTION, AZ
ZIP 85120
Phone: (480) 646-1001
Get Directions

Addie Roderick, FNP-BC is a family nurse practitioner in Apache Junction, AZ. Addie Roderick, FNP-BC NPI is 1447206529. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

105 S DELAWARE DR STE 2
APACHE JUNCTION, AZ
ZIP 85120-512
Phone: (480) 646-1001
Fax: (480) 646-1002

The enumeration date for this NPI number is 5/26/2006 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		APN6179	TENNESSEE	No
2	363LF0000X	Nurse Practitioner	Family	AP3930	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	78013760	MEDICAID	KENTUCKY
2	AP3930	OTHER	ARIZONA	LICENSE
3	653785	MEDICAID	ARIZONA
4	4087938	OTHER	TENNESSEE	BLUECROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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