Provider Demographics
NPI:1871299388
Name:RHODES, KATHY (RN, CBS)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:RN, CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 WINDERMERE BLVD APT B
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3532
Mailing Address - Country:US
Mailing Address - Phone:972-804-3487
Mailing Address - Fax:
Practice Address - Street 1:37 CALVERT DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3520
Practice Address - Country:US
Practice Address - Phone:318-443-9634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000261206163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant