Healthcare Provider Details

I. General information

NPI: 1629012786
Provider Name (Legal Business Name): STEPHANIE J RHODES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 CHARTER DR MEDICAL PAVILION AT HOWARD COUNTY-SUITE 200
COLUMBIA MD
21044-3128
US

IV. Provider business mailing address

2 MERIDIAN BLVD FL 2
WYOMISSING PA
19610-3202
US

V. Phone/Fax

Practice location:
  • Phone: 610-372-4957
  • Fax: 610-372-3735
Mailing address:
  • Phone: 610-372-4957
  • Fax: 610-372-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR140622
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: