Provider Demographics
NPI:1629781836
Name:MECKLE, RHONDA KAY
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAY
Last Name:MECKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:MCCLUSKY
Mailing Address - State:ND
Mailing Address - Zip Code:58463-0444
Mailing Address - Country:US
Mailing Address - Phone:701-220-8383
Mailing Address - Fax:
Practice Address - Street 1:518 AVE A EAST
Practice Address - Street 2:
Practice Address - City:MCCLUSKY
Practice Address - State:ND
Practice Address - Zip Code:58463
Practice Address - Country:US
Practice Address - Phone:701-220-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant