Provider Demographics
NPI:1467427005
Name:BROCKINGTON, RHONDA (FNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:BROCKINGTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 E 169TH ST
Mailing Address - Street 2:PRIVATE HOUSE- 1ST FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-1764
Mailing Address - Country:US
Mailing Address - Phone:718-860-6448
Mailing Address - Fax:
Practice Address - Street 1:819 E 169TH ST
Practice Address - Street 2:PRIVATE HOUSE- 1ST FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-1764
Practice Address - Country:US
Practice Address - Phone:718-860-6448
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333989-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily