MEDICARE: RHONDA JOYCE DEGREE LPN

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	164X00000X	Licensed Vocational Nurse	PN261870	PA

General Provider Information

NPI Number	:	1578108544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA JOYCE DEGREE LPN

Provider Business Mailing Address
First Line	:	126 WALSH RD
Second Line	:
City	:	EAST LANSDOWNE
State	:	PA
Zip	:	19050-2154
Country	:	US
Telephone Number	:	215-431-4810
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 WALSH RD
Second Line	:
City	:	EAST LANSDOWNE
State	:	PA
Zip	:	19050-2154
Country	:	US
Telephone Number	:	215-431-4810
Fax Number	:

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

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	01/08/2020

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