Provider Demographics
NPI:1740889666
Name:SMITH, RHONDA LYNN (NCMA)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:NCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3700
Mailing Address - Country:US
Mailing Address - Phone:517-782-0010
Mailing Address - Fax:
Practice Address - Street 1:2301 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3700
Practice Address - Country:US
Practice Address - Phone:517-782-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator