1790904696 NPI number — RHONDA L MALONEY MSN, NP-C

Table of content: RHONDA L MALONEY MSN, NP-C (NPI 1790904696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790904696 NPI number — RHONDA L MALONEY MSN, NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALONEY
Provider First Name:
RHONDA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790904696
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
610 JONES FERRY RD
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
CARRBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27510-6113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-929-1747
Provider Business Mailing Address Fax Number:
919-933-5168

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
610 JONES FERRY RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
CARRBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27510-6113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-929-1747
Provider Business Practice Location Address Fax Number:
919-933-5168
Provider Enumeration Date:
04/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  5007430 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 617570 . This is a "RN LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5007430 . This is a "NC LICENSE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: F0307021 . This is a "FAMILY NURSE PRACTITIONER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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