Basic Information
| Provider Information | |||||||||
| NPI: | 1295082063 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHOADS | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 CONTINENTAL DR | ||||||||
| Address2: | SUITE 406 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197134306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023682630 | ||||||||
| FaxNumber: | 3023681271 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 CONTINENTAL DR | ||||||||
| Address2: | SUITE 406 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197134306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023682630 | ||||||||
| FaxNumber: | 3023681271 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2012 | ||||||||
| LastUpdateDate: | 10/08/2014 | ||||||||
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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 | 163W00000X | L1-0035105 | DE | N | Nursing Service Providers | Registered Nurse | 363L00000X | LG-0000615 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 1295082063 | 05 | DE | MEDICAID |