Provider Demographics
NPI:1881948131
Name:MANNIX, RHONDA JEAN (DNP, APRN-CNS)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:JEAN
Last Name:MANNIX
Suffix:
Gender:F
Credentials:DNP, APRN-CNS
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:COLEMAN-JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1122 N.E. 13TH STREET
Mailing Address - Street 2:ORI 236
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1039
Mailing Address - Country:US
Mailing Address - Phone:405-271-3635
Mailing Address - Fax:
Practice Address - Street 1:1122 NE 13TH ST
Practice Address - Street 2:ORI 236
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1039
Practice Address - Country:US
Practice Address - Phone:405-650-9199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR42934364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health