Provider Demographics
NPI:1164790838
Name:ROCKWELL, RHIANNON MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:RHIANNON
Middle Name:MICHELLE
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:589 STONEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-2505
Mailing Address - Country:US
Mailing Address - Phone:952-435-3708
Mailing Address - Fax:
Practice Address - Street 1:589 STONEWOOD WAY
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-2505
Practice Address - Country:US
Practice Address - Phone:952-435-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN188722-2163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse