Provider Demographics
NPI:1902904790
Name:HERTWIG, RHONDA PATRICE (CPNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:PATRICE
Last Name:HERTWIG
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:PATRICE
Other - Last Name:HERTWIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPNP
Mailing Address - Street 1:46 WILD DEER TRL
Mailing Address - Street 2:
Mailing Address - City:ZIRCONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28790-8988
Mailing Address - Country:US
Mailing Address - Phone:828-693-8396
Mailing Address - Fax:
Practice Address - Street 1:110 CHADWICK SQUARE CT STE A
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-3238
Practice Address - Country:US
Practice Address - Phone:828-698-8135
Practice Address - Fax:828-698-8518
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004208363LP0200X
SC3626363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty