Provider Demographics
NPI:1194582064
Name:UDELL, RHONDA
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:UDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1167 FLEMING AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-5234
Mailing Address - Country:US
Mailing Address - Phone:231-288-0911
Mailing Address - Fax:
Practice Address - Street 1:1167 FLEMING AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5234
Practice Address - Country:US
Practice Address - Phone:231-288-0911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide