Provider Demographics
NPI:1689034621
Name:HARRISON, RHONDA LEONARD (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LEONARD
Last Name:HARRISON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2588
Mailing Address - Country:US
Mailing Address - Phone:706-226-5533
Mailing Address - Fax:706-428-0033
Practice Address - Street 1:1300 CLEO WAY
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8442
Practice Address - Country:US
Practice Address - Phone:706-226-5533
Practice Address - Fax:706-428-0033
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN118337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner