Provider Demographics
NPI:1104892660
Name:RHOADS, DOROTHY L (CRNP)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:L
Last Name:RHOADS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 COMPUTER RD
Mailing Address - Street 2:SUITE E 25
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1752
Mailing Address - Country:US
Mailing Address - Phone:215-366-1160
Mailing Address - Fax:215-366-1141
Practice Address - Street 1:2300 COMPUTER RD
Practice Address - Street 2:SUITE E 25
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1752
Practice Address - Country:US
Practice Address - Phone:215-366-1160
Practice Address - Fax:215-366-1141
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP001690G363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA184969Medicare PIN