Provider Demographics
NPI:1881810125
Name:DEPRIEST, RHONDA JO
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:JO
Last Name:DEPRIEST
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 1:599 COUNTY ROAD 51
Mailing Address - Street 2:
Mailing Address - City:PEDRO
Mailing Address - State:OH
Mailing Address - Zip Code:45659-8774
Mailing Address - Country:US
Mailing Address - Phone:740-643-0332
Mailing Address - Fax:
Practice Address - Street 1:599 COUNTY ROAD 51
Practice Address - Street 2:
Practice Address - City:PEDRO
Practice Address - State:OH
Practice Address - Zip Code:45659-8774
Practice Address - Country:US
Practice Address - Phone:740-643-0332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2426235OtherOH INDEPENDENT PROVIDER