Provider Demographics
NPI:1154775583
Name:MOULD, RHONDA MICHELLE (RN)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:MICHELLE
Last Name:MOULD
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 1:14908 TRUMBALL CIR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-7817
Mailing Address - Country:US
Mailing Address - Phone:281-795-5387
Mailing Address - Fax:
Practice Address - Street 1:14908 TRUMBALL CIR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-7817
Practice Address - Country:US
Practice Address - Phone:281-795-5387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK70382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily