Provider Demographics
NPI:1063604833
Name:PARIS, RHONDA J (NP)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:J
Last Name:PARIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5128 E STOP 11 RD
Mailing Address - Street 2:SUITE 34
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-6337
Mailing Address - Country:US
Mailing Address - Phone:317-885-8150
Mailing Address - Fax:317-885-9807
Practice Address - Street 1:5128 E STOP 11 RD
Practice Address - Street 2:SUITE 34
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-6337
Practice Address - Country:US
Practice Address - Phone:317-885-8150
Practice Address - Fax:317-885-9807
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN151560EEEEMedicare PIN