Provider Demographics
NPI:1669992251
Name:GANIM, RHONDA
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:GANIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OAK BRANCH DR STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2995
Mailing Address - Country:US
Mailing Address - Phone:336-272-8335
Mailing Address - Fax:336-272-8339
Practice Address - Street 1:5607 POPLAR HILL CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-6344
Practice Address - Country:US
Practice Address - Phone:336-324-3909
Practice Address - Fax:336-272-8339
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider