Basic Information
| Provider Information | |||||||||
| NPI: | 1053825760 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RHODES | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | CSA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9839 MISTY LN | ||||||||
| Address2: | |||||||||
| City: | HAYES | ||||||||
| State: | VA | ||||||||
| PostalCode: | 230724037 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 BERNARDINE DR | ||||||||
| Address2: | |||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236024404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578866000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2017 | ||||||||
| LastUpdateDate: | 11/17/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZC0007X | 4485 | VA | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Certified First Assistant |
No ID Information.