Provider Demographics
NPI:1104134543
Name:ANDRUS, RHONDA M (RN)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:M
Last Name:ANDRUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 N PARK ST
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-1437
Mailing Address - Country:US
Mailing Address - Phone:315-568-9412
Mailing Address - Fax:315-568-6718
Practice Address - Street 1:12 N PARK ST
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-1437
Practice Address - Country:US
Practice Address - Phone:315-568-9412
Practice Address - Fax:315-568-6718
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY534012 1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health