Provider Demographics
NPI:1407413339
Name:TOLBERT, RHONDALYNN SHARICE (NP-C)
Entity Type:Individual
Prefix:
First Name:RHONDALYNN
Middle Name:SHARICE
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4827 MACY WAY
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-2067
Mailing Address - Country:US
Mailing Address - Phone:850-260-2684
Mailing Address - Fax:
Practice Address - Street 1:1119 IOLA DR
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-6302
Practice Address - Country:US
Practice Address - Phone:850-260-2684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-27
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11007499363LF0000X
GA218115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily