Individual
MRS. RHONDA FELECIA SMITH BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERTIFIED NURSE PRAC
Contact information
Practice address
2720 E 3RD ST, DAYTON, OH 45403-2102
(937) 520-7889
(376) 303-6039
Mailing address
1101 LARONA RD, TROTWOOD, OH 45426
(937) 854-6514
(937) 708-5428
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
210745
OH
363L00000X
Nurse Practitioner
210745
OH
363LC1500X
Community Health Nurse Practitioner
Primary
RN.210745
OH
364SP0812X
Community Psychiatric/Mental Health Clinical Nurse Specialist
RN.210745
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2401047
—
OH
01
—
328140
ANTHEM BC
OH
01
—
492320001
CARE SOURCE
OH
Enumeration date
04/02/2007
Last updated
12/30/2024
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