Provider Demographics
NPI:1114363926
Name:MATTHEWS, RHONDA
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1649 HIGHWAY 52
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:SC
Mailing Address - Zip Code:29591-0129
Mailing Address - Country:US
Mailing Address - Phone:843-389-2531
Mailing Address - Fax:843-389-2548
Practice Address - Street 1:1649 US HWY 52
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:SC
Practice Address - Zip Code:29591-0129
Practice Address - Country:US
Practice Address - Phone:843-389-2531
Practice Address - Fax:843-389-2548
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC61193163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1245288901Medicaid