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NPI Code Detail

MEDICARE: RHONDA MALINA APN

MEDICARE: RHONDA MALINA APN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner129736TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720078561
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHONDA MALINA APN
Provider Business Mailing Address
First Line : PO BOX 37087
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3087
Country : US
Telephone Number : 828-687-5616
Fax Number : 828-650-8076
Provider Business Practice Location Address
First Line : 401 TAKOMA AVE
Second Line :
City : GREENEVILLE
State : TN
Zip : 37743-4647
Country : US
Telephone Number : 423-636-2425
Fax Number : 423-798-1266
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 06/15/2015

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