Provider Demographics
NPI:1619138930
Name:HANRAHAN, RHONDA SUE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:SUE
Last Name:HANRAHAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2779 BELGIUM RD
Mailing Address - Street 2:
Mailing Address - City:COLEMAN
Mailing Address - State:WI
Mailing Address - Zip Code:54112-9791
Mailing Address - Country:US
Mailing Address - Phone:715-927-3964
Mailing Address - Fax:
Practice Address - Street 1:1400 LOMBARDI AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-3922
Practice Address - Country:US
Practice Address - Phone:920-498-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4747-016124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist