Healthcare Provider Details

I. General information

NPI: 1154394435
Provider Name (Legal Business Name): CAROL M RHODES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 21ST AVE W
BRADENTON FL
34209-7847
US

IV. Provider business mailing address

6001 21ST AVE W
BRADENTON FL
34209-7847
US

V. Phone/Fax

Practice location:
  • Phone: 941-761-4448
  • Fax: 941-761-0235
Mailing address:
  • Phone: 941-761-4448
  • Fax: 941-761-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP3120242
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP 02208
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: