Provider Demographics
NPI:1326925082
Name:RODRIGUEZ, KAITLYN (CRNP)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 COVENTRY POINTE LN
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7487
Mailing Address - Country:US
Mailing Address - Phone:267-884-3480
Mailing Address - Fax:
Practice Address - Street 1:1503 COVENTRY POINTE LN
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7487
Practice Address - Country:US
Practice Address - Phone:267-884-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP033494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily