Provider Demographics
NPI:1659193738
Name:GRAY, RHONDA J (RN)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:J
Last Name:GRAY
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 1:4903 MIDDLEDALE RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2524
Mailing Address - Country:US
Mailing Address - Phone:330-840-1597
Mailing Address - Fax:
Practice Address - Street 1:4903 MIDDLEDALE RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2524
Practice Address - Country:US
Practice Address - Phone:330-840-1597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.283707163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse