Provider Demographics
NPI:1033582465
Name:GAETANO, RHONDA (RN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:GAETANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 140TH LN NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-7617
Mailing Address - Country:US
Mailing Address - Phone:763-498-3123
Mailing Address - Fax:
Practice Address - Street 1:1529 140TH LN NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-7617
Practice Address - Country:US
Practice Address - Phone:763-498-3123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 132881-7163WC2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence Care