Provider Demographics
NPI:1184134504
Name:CROSS, RHONDA LEE
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEE
Last Name:CROSS
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 1:18551 WOODLAND HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-9149
Mailing Address - Country:US
Mailing Address - Phone:276-206-9899
Mailing Address - Fax:276-628-8093
Practice Address - Street 1:18551 WOODLAND HILLS RD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-9149
Practice Address - Country:US
Practice Address - Phone:276-206-9899
Practice Address - Fax:276-628-8093
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0182991601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care