Provider Demographics
NPI:1316528300
Name:BRANTLEY, RHONDA MICHELLE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:MICHELLE
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8273 FM 1013 RD
Mailing Address - Street 2:
Mailing Address - City:HILLISTER
Mailing Address - State:TX
Mailing Address - Zip Code:77624-5123
Mailing Address - Country:US
Mailing Address - Phone:832-704-0777
Mailing Address - Fax:
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1031570363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care