Basic Information
| Provider Information | |||||||||
| NPI: | 1285770727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHOADS | ||||||||
| FirstName: | LORRAINE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N., P.H.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2344 OLD SONOMA RD | ||||||||
| Address2: | BUILDING G | ||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945593708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072534231 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2344 OLD SONOMA RD | ||||||||
| Address2: | BUILDING G | ||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945593708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072534231 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | L245077 | CA | Y | Nursing Service Providers | Registered Nurse | Community Health |
No ID Information.