Provider Demographics
NPI:1568648624
Name:RICHARDSON, RHONDA RAE (RN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:RAE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:RAE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3333 E VEST AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-8482
Mailing Address - Country:US
Mailing Address - Phone:480-279-6815
Mailing Address - Fax:480-279-6805
Practice Address - Street 1:3333 E VEST AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-8482
Practice Address - Country:US
Practice Address - Phone:480-279-6815
Practice Address - Fax:480-279-6805
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN116199163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool