Provider Demographics
NPI:1871131631
Name:LEGENDRE, RHONDA KAY (NP)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:KAY
Last Name:LEGENDRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18570 JOHNNIE B. HALL MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:ROSEPINE
Mailing Address - State:LA
Mailing Address - Zip Code:70659-4635
Mailing Address - Country:US
Mailing Address - Phone:337-462-1913
Mailing Address - Fax:
Practice Address - Street 1:18570 JOHNNIE B HALL MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:ROSEPINE
Practice Address - State:LA
Practice Address - Zip Code:70659
Practice Address - Country:US
Practice Address - Phone:337-462-1913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005020363LF0000X
LA213451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily