Provider Demographics
NPI:1679024780
Name:CANNING, RHONDA (RN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:CANNING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:ADAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4417 NE BLUE JAY DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-3208
Mailing Address - Country:US
Mailing Address - Phone:417-225-2066
Mailing Address - Fax:
Practice Address - Street 1:4417 NE BLUE JAY DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-3208
Practice Address - Country:US
Practice Address - Phone:417-225-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO122321163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse