Provider Demographics
NPI:1083939425
Name:RHOADS, MARILYN LOUISE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:LOUISE
Last Name:RHOADS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 LINKS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40067-6571
Mailing Address - Country:US
Mailing Address - Phone:502-410-1357
Mailing Address - Fax:
Practice Address - Street 1:615 WASHINGTON STREET
Practice Address - Street 2:MERCY CLINIC
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065
Practice Address - Country:US
Practice Address - Phone:502-647-4668
Practice Address - Fax:502-647-4615
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1048667164W00000X
KY2093P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No164W00000XNursing Service ProvidersLicensed Practical Nurse