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General NPI Number Information
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NPI Number | 1700907565
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Entity Type | Individual
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Provider Name | RHONDA FELECIA SMITH BASS CERTIFIED NURSE PRAC
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 2720 E 3RD ST
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City | DAYTON
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State | OH
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Zip | 45403-2102
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Country | US
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Telephone | 937-520-7889
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Fax | 376-303-6039
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Provider Business Mailing Address
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Address Line | 1101 LARONA RD
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City | TROTWOOD
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State | OH
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Zip | 45426
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Country | US
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Telephone | 937-854-6514
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Fax | 937-708-5428
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 210745
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 210745
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 364SP0812X
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Taxonomy Name | Community Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN.210745
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | RN.210745
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License Number State | OH
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