Provider Demographics
NPI:1023214251
Name:RHOADS MARTINEZ, RITA MARIE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:MARIE
Last Name:RHOADS MARTINEZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-1123
Mailing Address - Country:US
Mailing Address - Phone:717-786-3406
Mailing Address - Fax:
Practice Address - Street 1:1138 GEORGETOWN ROAD
Practice Address - Street 2:
Practice Address - City:BART
Practice Address - State:PA
Practice Address - Zip Code:17503-0152
Practice Address - Country:US
Practice Address - Phone:717-786-5506
Practice Address - Fax:717-786-5507
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP000162B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily