Provider Demographics
NPI:1245355114
Name:RHODES, KATRINA (MD)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:VA
Mailing Address - Zip Code:23149-0415
Mailing Address - Country:US
Mailing Address - Phone:804-758-2381
Mailing Address - Fax:
Practice Address - Street 1:2780 GENERAL PULLER HWY
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:VA
Practice Address - Zip Code:23149-3112
Practice Address - Country:US
Practice Address - Phone:804-758-2381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251927251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare