Healthcare Provider Details

I. General information

NPI: 1811854821
Provider Name (Legal Business Name): RHONDA RENEE PANKEY CPRM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 N MONROE ST
MONROE MI
48162-9297
US

IV. Provider business mailing address

3250 N MONROE ST
MONROE MI
48162-9297
US

V. Phone/Fax

Practice location:
  • Phone: 734-384-3402
  • Fax: 734-384-3420
Mailing address:
  • Phone: 910-262-2647
  • Fax: 910-262-2647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberM-00621
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: