Provider Demographics
NPI:1871027565
Name:HENRY, RHONITA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:RHONITA
Middle Name:
Last Name:HENRY
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 1:15610 BEAR VALLEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8822
Mailing Address - Country:US
Mailing Address - Phone:760-245-9999
Mailing Address - Fax:
Practice Address - Street 1:15610 BEAR VALLEY RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8822
Practice Address - Country:US
Practice Address - Phone:760-245-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily