Provider Demographics
NPI:1619581659
Name:DONNELLY, RHONDA KAYE (APRN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAYE
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2917 BROOKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-1407
Mailing Address - Country:US
Mailing Address - Phone:757-619-6228
Mailing Address - Fax:
Practice Address - Street 1:3010 E 138TH AVE STE 12
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3999
Practice Address - Country:US
Practice Address - Phone:813-975-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003315363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner