Provider Demographics
NPI:1366866998
Name:CANADA, RHONDA GAYLE (RN, IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:GAYLE
Last Name:CANADA
Suffix:
Gender:F
Credentials:RN, IBCLC, RLC
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:CANADA
Other - Last Name:YANOSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, IBCLC, RLC
Mailing Address - Street 1:43768 JENKINS LN
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4822
Mailing Address - Country:US
Mailing Address - Phone:703-723-6621
Mailing Address - Fax:
Practice Address - Street 1:43768 JENKINS LN
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4822
Practice Address - Country:US
Practice Address - Phone:703-723-6621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-49746163WL0100X
VA0001221796163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant