MEDICARE: RHONDA ANDERSON

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1639754401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA ANDERSON

Provider Business Mailing Address
First Line	:	12201 W NORTH AVE STE 102A
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2061
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12201 W NORTH AVE STE 102A
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2061
Country	:	US
Telephone Number	:	414-534-6562
Fax Number	:

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

Provider Enumeration Date	:	03/13/2021
Last Update Date	:	03/13/2021

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Directions to “ RHONDA ANDERSON ” Practice Location

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