Provider Demographics
NPI:1437664430
Name:SEBASTIAN, RHONDA L (APN)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:L
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:RHONDA LEE
Other - Middle Name:UCOL
Other - Last Name:SEBASTIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:107 BERLIN RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3526
Practice Address - Country:US
Practice Address - Phone:856-429-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00777000363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care