Provider Demographics
NPI:1821229915
Name:RAGSDALE, RHONDA (FNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37662
Mailing Address - Country:US
Mailing Address - Phone:423-857-2093
Mailing Address - Fax:423-857-2012
Practice Address - Street 1:105 WEST STONE DR.
Practice Address - Street 2:STE: 2A
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660
Practice Address - Country:US
Practice Address - Phone:423-230-2430
Practice Address - Fax:423-378-5940
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14228363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
103I086169Medicare UPIN