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Individual

KEVIN M RHODUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1397 WEIMER RD, TAOS, NM 87571-6253
(575) 758-8883
Mailing address
6 WAPITI LOOP, TAOS, NM 87571-7124
(505) 947-6660

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C-APN.0000892-C-CRNA
CO
367500000X
Certified Registered Nurse Anesthetist
R54743
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10020355
LOVELACE HP
NM
01
202000353
PRESBYTERIAN HP
NM
05
59332841
CO
05
956899
AZ
05
9829750
NM
01
NM006B15
BCBS
NM
01
P00329269
RR MEDICARE
NM
05
T0426
UT
Enumeration date
02/16/2006
Last updated
03/05/2018
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