Provider Demographics
NPI:1164960696
Name:MARTIN, RHONDA LYNN (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYNN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:LYNN
Other - Last Name:O'MALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5806 TIDEWATER PRESERVE BLVD
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-5740
Mailing Address - Country:US
Mailing Address - Phone:816-547-6296
Mailing Address - Fax:941-241-2998
Practice Address - Street 1:5250 17TH ST UNIT 101
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-8244
Practice Address - Country:US
Practice Address - Phone:941-203-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0003983-C-NP363LF0000X
KS53-77638-081363LF0000X
FL11009309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily