Provider Demographics
NPI:1295122208
Name:MCNICHOLS, RHIANNA MARIE (ARNP-C)
Entity type:Individual
Prefix:MISS
First Name:RHIANNA
Middle Name:MARIE
Last Name:MCNICHOLS
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:300 PINELLAS ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3804
Mailing Address - Country:US
Mailing Address - Phone:727-461-8231
Mailing Address - Fax:727-298-6637
Practice Address - Street 1:3231 MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6607
Practice Address - Country:US
Practice Address - Phone:727-725-6905
Practice Address - Fax:727-266-4931
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 923-7148363LF0000X
FLARNP9237148363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014813900Medicaid