Provider Demographics
NPI:1639570468
Name:RHODES, CHARLA MAY (LPN)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:MAY
Last Name:RHODES
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 1:229 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-1005
Mailing Address - Country:US
Mailing Address - Phone:440-228-9712
Mailing Address - Fax:
Practice Address - Street 1:229 ELM ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-1005
Practice Address - Country:US
Practice Address - Phone:440-228-9712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN157145164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse