Provider Demographics
NPI:1245253921
Name:RHODES, TAMARA L (RN, MSN, ARNP-BC)
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:L
Last Name:RHODES
Suffix:
Gender:F
Credentials:RN, MSN, ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 MURDOCH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-1026
Mailing Address - Country:US
Mailing Address - Phone:304-485-2700
Mailing Address - Fax:304-485-0481
Practice Address - Street 1:517 36TH ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-1006
Practice Address - Country:US
Practice Address - Phone:304-485-1044
Practice Address - Fax:304-422-1861
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV25520363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVNP00333Medicare PIN