Provider Demographics
NPI:1902390982
Name:RHODES, HANEEFAH OMEGA HENRY (MSN, AAS, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HANEEFAH
Middle Name:OMEGA HENRY
Last Name:RHODES
Suffix:
Gender:F
Credentials:MSN, AAS, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VSU HEALTH CENTER
Mailing Address - Street 2:1 HAYDEN DR
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-2520
Mailing Address - Country:US
Mailing Address - Phone:804-524-3664
Mailing Address - Fax:
Practice Address - Street 1:VSU HEALTH CENTER 1 HAYDEN DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23806-0001
Practice Address - Country:US
Practice Address - Phone:804-524-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176093363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care