Provider Demographics
NPI:1326004904
Name:HUMMEL, RHONDA K (PA-C)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:K
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 S ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73150-6900
Mailing Address - Country:US
Mailing Address - Phone:405-733-5050
Mailing Address - Fax:
Practice Address - Street 1:8300 S ANDERSON RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73150-6900
Practice Address - Country:US
Practice Address - Phone:405-733-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1518363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200074860AMedicaid
OK200074860AMedicaid
OK248605101Medicare ID - Type Unspecified