Provider Demographics
NPI:1194975003
Name:RHOADES, CLAUDETTE (FNP)
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:
Last Name:RHOADES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 HWAY 95
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-8199
Mailing Address - Country:US
Mailing Address - Phone:928-444-1444
Mailing Address - Fax:928-444-1445
Practice Address - Street 1:3735 HWAY 95
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-8199
Practice Address - Country:US
Practice Address - Phone:928-444-1444
Practice Address - Fax:928-444-1444
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-27
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP21518363LF0000X
AZAP4705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily