Provider Demographics
NPI:1992269013
Name:PIERCE, RHONDA J
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:J
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:J
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:45 N CANFIELD NILES RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2343
Mailing Address - Country:US
Mailing Address - Phone:330-330-8777
Mailing Address - Fax:
Practice Address - Street 1:45 N CANFIELD NILES RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2343
Practice Address - Country:US
Practice Address - Phone:330-330-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127151164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse