Provider Demographics
NPI:1144601410
Name:RHODES, CHANDRA (CNP)
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6129 NASBY DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8291
Mailing Address - Country:US
Mailing Address - Phone:513-587-5533
Mailing Address - Fax:317-936-3028
Practice Address - Street 1:6129 NASBY DR
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8291
Practice Address - Country:US
Practice Address - Phone:513-225-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4042864363LG0600X, 163W00000X
OHRN.363366363LA2100X
OHCOA 17711 NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse