Healthcare Provider Details

I. General information

NPI: 1568648624
Provider Name (Legal Business Name): RHONDA RAE RICHARDSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RHONDA RAE ROBINSON RN

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 E VEST AVE
GILBERT AZ
85295-8482
US

IV. Provider business mailing address

3333 E VEST AVE
GILBERT AZ
85295-8482
US

V. Phone/Fax

Practice location:
  • Phone: 480-279-6815
  • Fax: 480-279-6805
Mailing address:
  • Phone: 480-279-6815
  • Fax: 480-279-6805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN116199
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: