Provider Demographics
NPI:1336335363
Name:SMITH, RHONDA RENEE (NNP)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:RENEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:MRS
Other - First Name:RHONDA
Other - Middle Name:RENEE
Other - Last Name:EBERHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:107 TOPEKA RD
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583
Mailing Address - Country:US
Mailing Address - Phone:337-873-9275
Mailing Address - Fax:
Practice Address - Street 1:1301 CONCORD TERRACE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323
Practice Address - Country:US
Practice Address - Phone:800-243-3839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN099317163W00000X
LAAP04903363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse