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Individual

CARRIE RHODES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5356 KINGFISHERS CT, TALLAHASSEE, FL 32303-8918
(850) 524-4921
Mailing address
5356 KINGFISHERS CT, TALLAHASSEE, FL 32303-8918

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5199913
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
686606996
MEDICAID NUMBER
FL
05
686606998
FL
Enumeration date
05/25/2012
Last updated
05/25/2012
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