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General NPI Number Information
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NPI Number | 1801289012
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Entity Type | Individual
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Provider Name | RHONDA L MICKNA MSN, AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 01/04/2026
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Provider Practice Location Address
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Address Line | 8046 CLEVELAND RD
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City | WOOSTER
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State | OH
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Zip | 44691-7702
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Country | US
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Telephone | 330-347-3685
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Fax |
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Provider Business Mailing Address
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Address Line | 8046 CLEVELAND RD
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City | WOOSTER
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State | OH
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Zip | 44691-7702
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Country | US
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Telephone | 330-347-3685
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRNCNP0040912
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.411834
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License Number State | OH
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