Provider Demographics
NPI:1609158831
Name:RHOADS, CATHY ANN (LPN)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:RHOADS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 A EAST HWY 66
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036
Mailing Address - Country:US
Mailing Address - Phone:405-262-7631
Mailing Address - Fax:405-262-8099
Practice Address - Street 1:1631 A EAST HWY 66
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036
Practice Address - Country:US
Practice Address - Phone:405-262-7631
Practice Address - Fax:405-262-8099
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL 0028539164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse