Provider Demographics
NPI:1912136441
Name:GERHARTZ, RHONDA DENISE (RN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:DENISE
Last Name:GERHARTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:DENISE
Other - Last Name:MAIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:W8716 PHEASANT RUN
Mailing Address - Street 2:
Mailing Address - City:HORTONVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54944-8719
Mailing Address - Country:US
Mailing Address - Phone:920-779-0504
Mailing Address - Fax:
Practice Address - Street 1:W8716 PHEASANT RUN
Practice Address - Street 2:
Practice Address - City:HORTONVILLE
Practice Address - State:WI
Practice Address - Zip Code:54944-8719
Practice Address - Country:US
Practice Address - Phone:920-779-0504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI114138163W00000X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH1000XNursing Service ProvidersRegistered NurseHospice