Provider Demographics
NPI:1386443257
Name:KIMMONS, RHONDA LEE
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEE
Last Name:KIMMONS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PARCOAL RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:26288-9767
Mailing Address - Country:US
Mailing Address - Phone:304-462-2948
Mailing Address - Fax:
Practice Address - Street 1:70 PARCOAL RD
Practice Address - Street 2:
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-9767
Practice Address - Country:US
Practice Address - Phone:304-462-2948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator