Provider Demographics
NPI:1760706394
Name:ADAMS, RHONDA JEAN (PN 123923)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:JEAN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PN 123923
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3466 BELLFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2182
Mailing Address - Country:US
Mailing Address - Phone:440-986-1328
Mailing Address - Fax:
Practice Address - Street 1:525 FURNACE ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-3529
Practice Address - Country:US
Practice Address - Phone:440-610-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 123923164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse