Provider Demographics
NPI:1871322099
Name:GARCIA-RODRIGUEZ, CERAFINA CRYSTAL (FNP-BC)
Entity type:Individual
Prefix:
First Name:CERAFINA
Middle Name:CRYSTAL
Last Name:GARCIA-RODRIGUEZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 COVERED WAGON RD
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9651
Mailing Address - Country:US
Mailing Address - Phone:336-995-0460
Mailing Address - Fax:
Practice Address - Street 1:4215 W WENDOVER AVE STE L
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1922
Practice Address - Country:US
Practice Address - Phone:833-667-2967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily