Provider Demographics
NPI:1316192875
Name:DEXTER, RHONDA D (RN, LM)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:D
Last Name:DEXTER
Suffix:
Gender:F
Credentials:RN, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 STATE ROAD 207
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:FL
Mailing Address - Zip Code:32033-3433
Mailing Address - Country:US
Mailing Address - Phone:904-692-2967
Mailing Address - Fax:904-692-2967
Practice Address - Street 1:6825 STATE ROAD 207
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:FL
Practice Address - Zip Code:32033-3433
Practice Address - Country:US
Practice Address - Phone:904-692-2967
Practice Address - Fax:904-692-2967
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW111176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife