Provider Demographics
NPI:1073923025
Name:REXRODE, ANN S (RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:S
Last Name:REXRODE
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4124
Mailing Address - Country:US
Mailing Address - Phone:864-953-6303
Mailing Address - Fax:864-942-2199
Practice Address - Street 1:1736 MAIN ST S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4124
Practice Address - Country:US
Practice Address - Phone:864-953-6303
Practice Address - Fax:864-942-2199
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC00040930163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health