Provider Demographics
NPI:1497903736
Name:RHOADS, B. F (RN/CWS)
Entity Type:Individual
Prefix:
First Name:B.
Middle Name:F
Last Name:RHOADS
Suffix:
Gender:M
Credentials:RN/CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72153-0508
Mailing Address - Country:US
Mailing Address - Phone:501-723-8357
Mailing Address - Fax:
Practice Address - Street 1:1743 OLD HICKORY DR.
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:AR
Practice Address - Zip Code:72153
Practice Address - Country:US
Practice Address - Phone:501-723-8357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR44436163W00000X
AR0681163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care