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General NPI Number Information
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NPI Number | 1619138930
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Entity Type | Individual
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Provider Name | RHONDA SUE HANRAHAN RDH
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Gender | Female
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 1400 LOMBARDI AVE SUITE 202
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City | GREEN BAY
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State | WI
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Zip | 54304-3922
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Country | US
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Telephone | 920-498-8877
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Fax |
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Provider Business Mailing Address
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Address Line | N2779 BELGIUM RD
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City | COLEMAN
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State | WI
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Zip | 54112-9791
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Country | US
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Telephone | 715-927-3964
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 4747-016
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License Number State | WI
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