Provider Demographics
NPI:1073495453
Name:RHYNES, BERNICE R
Entity type:Individual
Prefix:
First Name:BERNICE
Middle Name:R
Last Name:RHYNES
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 1:3213 OBLONG CIR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-8934
Mailing Address - Country:US
Mailing Address - Phone:850-630-3811
Mailing Address - Fax:
Practice Address - Street 1:3213 OBLONG CIR
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-8934
Practice Address - Country:US
Practice Address - Phone:850-630-3811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL02320249Z372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion