MEDICARE: RHONDA O GILLETTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	225400000X	OTHER	NV	REHABILITATION PRACTITIONER

General Provider Information

NPI Number	:	1548520653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA O GILLETTE

Provider Business Mailing Address
First Line	:	4325 W ROME BLVD
Second Line	:	#3197
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5497
Country	:	US
Telephone Number	:	702-409-8155
Fax Number	:

Provider Business Practice Location Address
First Line	:	4325 W ROME BLVD
Second Line	:	#3197
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5497
Country	:	US
Telephone Number	:	702-409-8155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2012
Last Update Date	:	10/15/2013

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Directions to “ RHONDA O GILLETTE ” Practice Location

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