Provider Demographics
NPI:1457796237
Name:RHOADES, ALICIA H (RN)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:H
Last Name:RHOADES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7753 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-8944
Mailing Address - Country:US
Mailing Address - Phone:843-818-1424
Mailing Address - Fax:843-824-8729
Practice Address - Street 1:7753 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-8944
Practice Address - Country:US
Practice Address - Phone:843-818-1424
Practice Address - Fax:843-824-8729
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC75329163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse