Provider Demographics
NPI:1134574452
Name:ESHUN, RHODALINE (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:RHODALINE
Middle Name:
Last Name:ESHUN
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4203 ARBOR WOOD CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-3134
Mailing Address - Country:US
Mailing Address - Phone:646-249-7355
Mailing Address - Fax:
Practice Address - Street 1:329 HOWE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1648
Practice Address - Country:US
Practice Address - Phone:646-249-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY713494251E00000X
MDR23744363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No251E00000XAgenciesHome Health