Lydia Rodriguez, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

9873492-4405 Issued in UT

Practice address

90 Hope Dr BLDG 6000
Mountain Home Afb, ID 83648-1062

Phone

(208) 828-7111

Fax

(208) 828-7902

NPI assigned

Apr 13, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1790149961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOPE DRVE",
            "address_2": "BLDG 6000",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "83648",
            "telephone_number": "208-828-7200",
            "fax_number": "208-828-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOPE DR BLDG 6000",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "836481062",
            "telephone_number": "208-828-7111",
            "fax_number": "208-828-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LYDIA",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "IN",
            "license": "28164518A",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "9873492-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Azalea Pope, PA-C
• Stephen Sterling Potter, DDS
• Amanda Marie Ralston, PA
• Marissa Redding, COTA
• Dennis Jacob Reuter, IDMT
• Paul Sahwell, PH.D.
• Eva Elaine Schauer, NP-C
• Jacqueline A Shafer, LCSW
• Erin Siebert, PHD
• Geremy Skeen, PHARMD

• Women's Health Nurse Practitioner in Mountain Home Afb, ID
• Providers in Mountain Home Afb, ID by specialty
• Women's Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.