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General NPI Number Information
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NPI Number | 1912677006
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Entity Type | Individual
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Provider Name | AUDRA LUANNE RHINEHARDT PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 111 CLARA BARTON ST
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City | DANSVILLE
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State | NY
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Zip | 14437-9527
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Country | US
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Telephone | 585-355-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 5404 FREEDOM LN APT 305
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City | JAMESTOWN
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State | NC
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Zip | 27282-7824
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Country | US
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Telephone | 252-723-7158
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 27665
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-11634
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License Number State | NC
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