Provider Demographics
NPI:1548516149
Name:RHOE, MICHELE RENAE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:RENAE
Last Name:RHOE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:RENAE
Other - Last Name:PENTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:201 CONCOURSE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5640
Mailing Address - Country:US
Mailing Address - Phone:804-549-4030
Mailing Address - Fax:804-549-4030
Practice Address - Street 1:201 CONCOURSE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5640
Practice Address - Country:US
Practice Address - Phone:804-549-4030
Practice Address - Fax:804-549-4030
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055568363AM0700X
VA0110004805363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical