Healthcare Provider Details

I. General information

NPI: 1578087243
Provider Name (Legal Business Name): MONICA RHODES APRN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA CAMERO

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 NW 31ST ST
LAWTON OK
73505-6100
US

IV. Provider business mailing address

104 NW 31ST ST
LAWTON OK
73505-6100
US

V. Phone/Fax

Practice location:
  • Phone: 580-536-2121
  • Fax: 580-536-2150
Mailing address:
  • Phone: 580-536-2121
  • Fax: 580-536-2150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number83202
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: