Provider Demographics
NPI:1851700231
Name:GARBER, RONDA RAE (RN)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:RAE
Last Name:GARBER
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 1:5230 N DESERT LN
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-4313
Mailing Address - Country:US
Mailing Address - Phone:720-935-9503
Mailing Address - Fax:
Practice Address - Street 1:726 GAIL GARDNER WAY
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2314
Practice Address - Country:US
Practice Address - Phone:928-778-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ243304163W00000X
CO1619563163WG0600X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No282N00000XHospitalsGeneral Acute Care Hospital