Provider Demographics
NPI:1205072816
Name:HALLIDAY, RHODA ANN (FNP)
Entity type:Individual
Prefix:MS
First Name:RHODA
Middle Name:ANN
Last Name:HALLIDAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 DOYLE PARK DRIVE
Mailing Address - Street 2:SUITE G04
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-6648
Mailing Address - Country:US
Mailing Address - Phone:707-573-8984
Mailing Address - Fax:707-573-0982
Practice Address - Street 1:500 DOYLE PARK DR
Practice Address - Street 2:SUITE G04
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4558
Practice Address - Country:US
Practice Address - Phone:707-573-8984
Practice Address - Fax:707-573-0982
Is Sole Proprietor?:No
Enumeration Date:2009-01-02
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily