Healthcare Provider Details
I. General information
NPI: 1245253921
Provider Name (Legal Business Name): TAMARA L RHODES RN, MSN, ARNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/25/2006
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
517 36TH ST
PARKERSBURG WV
26101-1006
US
IV. Provider business mailing address
3605 MURDOCH AVE
PARKERSBURG WV
26101-1026
US
V. Phone/Fax
- Phone: 304-485-1044
- Fax: 304-422-1861
- Phone: 304-485-2700
- Fax: 304-485-0481
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 25520 |
| License Number State | WV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: