MEDICARE: RHONDA WHITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1043109382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA WHITE

Provider Business Mailing Address
First Line	:	1694 W BUENA VISTA ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238-3608
Country	:	US
Telephone Number	:	947-258-5712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1694 W BUENA VISTA ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238-3608
Country	:	US
Telephone Number	:	947-258-5712
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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Directions to “ RHONDA WHITE ” Practice Location

Language	Start Address	Practice Location

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