Provider Demographics
NPI:1629946553
Name:RHOADS, TRAYCE (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TRAYCE
Middle Name:
Last Name:RHOADS
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 LAND GRANT ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-2263
Mailing Address - Country:US
Mailing Address - Phone:904-747-2157
Mailing Address - Fax:
Practice Address - Street 1:135 LAND GRANT ST
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-2263
Practice Address - Country:US
Practice Address - Phone:904-747-2157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11043032363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health