Provider Demographics
NPI:1811888555
Name:AVILA, RHONDA SUE
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:SUE
Last Name:AVILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 N GRANT ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-1310
Mailing Address - Country:US
Mailing Address - Phone:308-325-8851
Mailing Address - Fax:
Practice Address - Street 1:1611 N GRANT ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1310
Practice Address - Country:US
Practice Address - Phone:308-325-8851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH13412073251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health