Healthcare Provider Details

I. General information

NPI: 1427414416
Provider Name (Legal Business Name): REBECCA RHONE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2016
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 OTTAWA RD POB 360
NEODESHA KS
66757-1897
US

IV. Provider business mailing address

2600 OTTAWA RD
NEODESHA KS
66757-1897
US

V. Phone/Fax

Practice location:
  • Phone: 620-325-2611
  • Fax: 620-325-8459
Mailing address:
  • Phone: 620-325-2611
  • Fax: 620-325-8453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number53-75024-082
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number53-75024-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: