Provider Demographics
NPI:1124013065
Name:ROY, RHONDA A (MS, ARNP-BC)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:A
Last Name:ROY
Suffix:
Gender:F
Credentials:MS, ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 ROGERS PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3022
Mailing Address - Country:US
Mailing Address - Phone:785-766-6567
Mailing Address - Fax:785-856-1177
Practice Address - Street 1:1201 WAKARUSA DR
Practice Address - Street 2:SUITE E2
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4722
Practice Address - Country:US
Practice Address - Phone:785-766-6567
Practice Address - Fax:785-856-1177
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45246363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS160905Medicare ID - Type Unspecified
KSQ22113Medicare UPIN