Provider Demographics
NPI:1467491290
Name:TOOLE, RONDA (APRN)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:
Last Name:TOOLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12234 PANAMA CITY BEACH PKWY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-2725
Mailing Address - Country:US
Mailing Address - Phone:850-233-2323
Mailing Address - Fax:850-233-1055
Practice Address - Street 1:12234 PANAMA CITY BEACH PKWY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-2725
Practice Address - Country:US
Practice Address - Phone:850-233-2323
Practice Address - Fax:850-233-1055
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN-11028345363LF0000X
GARN113445163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA806868882AMedicaid
GAP00363830OtherRR MEDICARE
GA806868882CMedicaid
GA806868882DMedicaid
GA806868882BMedicaid
GA50BBKWGMedicare PIN
GA806868882CMedicaid