Provider Demographics
NPI:1740507003
Name:SKINNER, RHONDA (PCA)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4727
Mailing Address - Country:US
Mailing Address - Phone:757-925-2856
Mailing Address - Fax:
Practice Address - Street 1:406 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-1324
Practice Address - Country:US
Practice Address - Phone:757-338-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101446471374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide