Provider Demographics
NPI:1548599723
Name:REID, RHONDA LORRAINE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LORRAINE
Last Name:REID
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 S CIRBY WAY APT 160
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4971
Mailing Address - Country:US
Mailing Address - Phone:916-872-8989
Mailing Address - Fax:
Practice Address - Street 1:1900 S CIRBY WAY APT 160
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4971
Practice Address - Country:US
Practice Address - Phone:916-872-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481384163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse