Provider Demographics
NPI:1568464733
Name:BEARD, RHONDA ADCOCK (FNP-C)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:ADCOCK
Last Name:BEARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:ADCOCK
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP, PMHNP
Mailing Address - Street 1:801 STUBBS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5566
Mailing Address - Country:US
Mailing Address - Phone:318-801-8868
Mailing Address - Fax:
Practice Address - Street 1:801 STUBBS AVE STE C
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5566
Practice Address - Country:US
Practice Address - Phone:318-654-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK24126163WG0000X
LARN087960163WG0000X
NMR57620363L00000X
LAAP03883363LF0000X, 363LP0808X
AK819363LF0000X
LA03883363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1104698Medicaid
LA1104698Medicaid
LA1104698Medicaid
AK4B920Medicare ID - Type Unspecified