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General NPI Number Information
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NPI Number | 1437201605
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Entity Type | Individual
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Provider Name | PHYLLIS WANDA RHYMES-JOHNSON ARNP,MSN,DHS-STUDENT
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | JACKSON HEALTH SYSTEM - 1611 N.W. 12TH AVENUE DEVICE CENTER - WW 407
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City | MIAMI
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State | FL
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Zip | 33169
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Country | US
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Telephone | 305-585-7443
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Fax | 305-585-6872
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Provider Business Mailing Address
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Address Line | 870 N.W. 177TH TERRACE
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City | MIAMI
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State | FL
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Zip | 33169
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Country | US
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Telephone | 305-793-9612
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Fax | 305-653-9882
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1060592
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License Number State | FL
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