Healthcare Provider Details

I. General information

NPI: 1316483480
Provider Name (Legal Business Name): RHONDA ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9820 E 41ST ST SUITE 301
TULSA OK
74146
US

IV. Provider business mailing address

4032 CASTOR AVE
PHILADELPHIA PA
19124-5338
US

V. Phone/Fax

Practice location:
  • Phone: 918-317-0270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN605584
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: