Provider Demographics
NPI:1689866170
Name:BOONE, RHONDA GAYLE (ARNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:GAYLE
Last Name:BOONE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:GAYLE
Other - Last Name:HANNAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 480W
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-762-1547
Mailing Address - Fax:270-752-2854
Practice Address - Street 1:300 S 8TH ST STE 509E
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2403
Practice Address - Country:US
Practice Address - Phone:270-759-4000
Practice Address - Fax:270-752-2857
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005090364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100157070Medicaid
KYK016220Medicare PIN