Provider Demographics
NPI:1215359898
Name:LARREAU, RHONDA JEAN (RN)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:JEAN
Last Name:LARREAU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:RHONDA
Other - Middle Name:JEAN
Other - Last Name:FIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10325 RIDGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-7316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10325 RIDGE PARK DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-7316
Practice Address - Country:US
Practice Address - Phone:715-210-2433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI153769-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse