Provider Demographics
NPI:1528019122
Name:TREADAWAY, RHONDA K HARVEY (FNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:K HARVEY
Last Name:TREADAWAY
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 1:10902 COYOTE CT
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 N UNION AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4194
Practice Address - Country:US
Practice Address - Phone:830-643-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228362363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041486404Medicaid
TX041486406Medicaid
TX041486415Medicaid
TX86N806OtherBCBS
TX8N3439OtherBCBS
TX8N9918OtherBCBS
TX041486401Medicaid
TX8N2960OtherBCBS
TX157228101Medicaid
TX8N9628OtherBCBS
TXS77927Medicare UPIN
TX041486406Medicaid
TXP00008430Medicare PIN
TX8N9918OtherBCBS
TX041486401Medicaid
TX8L18017Medicare PIN
TX8G4010Medicare PIN
TX8A5040Medicare PIN