Provider Demographics
NPI:1750158333
Name:RHODES, DENNISHA FULLER (MSN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DENNISHA
Middle Name:FULLER
Last Name:RHODES
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:MS
Other - First Name:DENNISHA
Other - Middle Name:
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26317 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH DINWIDDIE
Mailing Address - State:VA
Mailing Address - Zip Code:23803-2727
Mailing Address - Country:US
Mailing Address - Phone:804-524-7000
Mailing Address - Fax:
Practice Address - Street 1:26317 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH DINWIDDIE
Practice Address - State:VA
Practice Address - Zip Code:23803-2727
Practice Address - Country:US
Practice Address - Phone:804-524-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188677363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health