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General NPI Number Information
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NPI Number | 1639216344
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Entity Type | Individual
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Provider Name | RODNEY KENNETH SIAU FNP-C
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 803 N JACKSON ST
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City | ALBANY
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State | GA
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Zip | 31701-2313
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Country | US
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Telephone | 229-435-0832
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Fax | 229-435-2857
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Provider Business Mailing Address
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Address Line | PO BOX 71763
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City | ALBANY
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State | GA
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Zip | 31708-1763
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Country | US
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Telephone | 229-995-4832
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Fax | 229-435-2857
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN100140
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License Number State | GA
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