Provider Demographics
NPI:1346379104
Name:RHODEMAN, ALISON INEZ (LPN)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:INEZ
Last Name:RHODEMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7915B 45TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87116-5506
Mailing Address - Country:US
Mailing Address - Phone:602-620-9691
Mailing Address - Fax:
Practice Address - Street 1:377TH MEDICAL GROUP 1501 SAN PEDRO STREET BUILDING 47
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87117-5291
Practice Address - Country:US
Practice Address - Phone:505-846-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM67359164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ171290Medicaid