Provider Demographics
NPI:1295082063
Name:RHOADS, BRITTANY A (FNP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:A
Last Name:RHOADS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CONTINENTAL DR
Mailing Address - Street 2:SUITE 406
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4306
Mailing Address - Country:US
Mailing Address - Phone:302-368-2630
Mailing Address - Fax:302-368-1271
Practice Address - Street 1:111 CONTINENTAL DR
Practice Address - Street 2:SUITE 406
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4306
Practice Address - Country:US
Practice Address - Phone:302-368-2630
Practice Address - Fax:302-368-1271
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0035105163W00000X
DELG-0000615363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1295082063Medicaid
DE245770ZAG8Medicare PIN