Healthcare Provider Details

I. General information

NPI: 1235231416
Provider Name (Legal Business Name): JANELLE RHYNE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 160/163 BLDG KA2010
KAYENTA AZ
86033-0368
US

IV. Provider business mailing address

PO BOX 368 HWY 160/163 BLDG KA2010
KAYENTA AZ
86033-0368
US

V. Phone/Fax

Practice location:
  • Phone: 928-697-4000
  • Fax: 928-697-4145
Mailing address:
  • Phone: 928-697-4000
  • Fax: 928-697-4145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number28322
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: