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General NPI Number Information
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NPI Number | 1568289486
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Entity Type | Individual
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Provider Name | RHONDA HACKER APRN-PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 200 BELMONT AVE
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City | SOMERSET
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State | KY
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Zip | 42501-2419
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Country | US
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Telephone | 606-687-2038
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Fax | 606-200-3654
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Provider Business Mailing Address
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Address Line | 609 MOORE RD
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City | WILLIAMSBURG
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State | KY
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Zip | 40769-2084
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Country | US
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Telephone | 606-521-6684
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4027842
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License Number State | KY
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