Provider Demographics
NPI:1265933238
Name:ABBOTT, RHONDA ANN (LVN)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ANN
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 PR 4201
Mailing Address - Street 2:
Mailing Address - City:TALPA
Mailing Address - State:TX
Mailing Address - Zip Code:76882
Mailing Address - Country:US
Mailing Address - Phone:325-669-7147
Mailing Address - Fax:
Practice Address - Street 1:219 PR 4201
Practice Address - Street 2:
Practice Address - City:TALPA
Practice Address - State:TX
Practice Address - Zip Code:76882
Practice Address - Country:US
Practice Address - Phone:325-669-7147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX175868164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164X00000XMedicaid