Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 110566 | NC |
NPI | 1073611844 |
---|---|
Provider Name | Ms. Ginger A. Rhodes-Ryan |
First Address | Raleigh, NC 27610-1247 |
Second Address | Raleigh, NC 27610-1231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7000295 | (05) | NC |
P50417 | (02) |