Provider Demographics
NPI:1205080942
Name:MONTIEL, RHONDA KAY (LPN)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAY
Last Name:MONTIEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 HUMPHREY AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-9006
Mailing Address - Country:US
Mailing Address - Phone:928-587-1889
Mailing Address - Fax:
Practice Address - Street 1:6305 HUMPHREY AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-9006
Practice Address - Country:US
Practice Address - Phone:928-587-1889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP040316164W00000X
MI4703104044164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse