Provider Demographics
NPI:1265754469
Name:OLOWOFELA, RHONDA DENISE (LPN)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:DENISE
Last Name:OLOWOFELA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:RHONDA
Other - Middle Name:DENISE
Other - Last Name:ALBEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12136 198TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1141
Mailing Address - Country:US
Mailing Address - Phone:718-276-0995
Mailing Address - Fax:
Practice Address - Street 1:12136 198TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-1141
Practice Address - Country:US
Practice Address - Phone:718-276-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10 283080164W00000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program