Provider Demographics
NPI:1871051573
Name:BARBER-ANDERSON, RHONDA MIGNON (LPN)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:MIGNON
Last Name:BARBER-ANDERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:M
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:16000 BRINGARD DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-1421
Mailing Address - Country:US
Mailing Address - Phone:313-888-5582
Mailing Address - Fax:
Practice Address - Street 1:16000 BRINGARD DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-1421
Practice Address - Country:US
Practice Address - Phone:313-888-5582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703106565164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse