Provider Demographics
NPI:1164297511
Name:BLACKWOOD, RHODA VERONICA
Entity Type:Individual
Prefix:
First Name:RHODA
Middle Name:VERONICA
Last Name:BLACKWOOD
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 1:2914 E JOPPA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3045
Mailing Address - Country:US
Mailing Address - Phone:410-961-6850
Mailing Address - Fax:410-882-0790
Practice Address - Street 1:2914 E JOPPA RD STE 201
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-3045
Practice Address - Country:US
Practice Address - Phone:410-961-6850
Practice Address - Fax:410-882-0790
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide