Provider Demographics
NPI:1194014340
Name:ASCANIO, RHODA MAE (APRN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:RHODA
Middle Name:MAE
Last Name:ASCANIO
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:67 PRESIDENT ST., SUITE 410 SOUTH
Mailing Address - Street 2:MSC 861
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425
Mailing Address - Country:US
Mailing Address - Phone:843-792-5421
Mailing Address - Fax:843-792-5432
Practice Address - Street 1:67 PRESIDENT ST STE 410
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-5712
Practice Address - Country:US
Practice Address - Phone:843-792-5421
Practice Address - Fax:843-792-5432
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC3445363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1806Medicaid
SCNP1806Medicaid