Provider Demographics
NPI:1679244586
Name:OKOTH, RHONDA G (RN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:G
Last Name:OKOTH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2198 SOUTHERN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0383
Mailing Address - Country:US
Mailing Address - Phone:901-218-0206
Mailing Address - Fax:
Practice Address - Street 1:2198 SOUTHERN WOODS DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0383
Practice Address - Country:US
Practice Address - Phone:901-218-0206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN203529163W00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN203529OtherNURSING LICENSE