Provider Demographics
NPI:1114153293
Name:RHODES, MANDI BROOKE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MANDI
Middle Name:BROOKE
Last Name:RHODES
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1400 SE 4TH ST
Mailing Address - Street 2:STE H
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-7329
Mailing Address - Country:US
Mailing Address - Phone:405-799-7400
Mailing Address - Fax:405-799-7405
Practice Address - Street 1:1400 SE 4TH ST
Practice Address - Street 2:STE H
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-7329
Practice Address - Country:US
Practice Address - Phone:405-799-7400
Practice Address - Fax:405-799-7405
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2020-09-01
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Provider Licenses
StateLicense IDTaxonomies
OK1836363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical