Provider Demographics
NPI:1194259879
Name:RHODES, BAHTRENA (NP)
Entity type:Individual
Prefix:
First Name:BAHTRENA
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BAHTRENA
Other - Middle Name:
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1030 W MICHIGAN ST STE 2406
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5201
Practice Address - Country:US
Practice Address - Phone:317-962-3400
Practice Address - Fax:317-963-5446
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28196661A363LA2200X
IN71007647A207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health