Rhonda Renae Pettaway Ansier
Nurse Practitioner, Family in Olympia Fields, IL. Individual provider (NPI-1).
NPI number1114533841
StatusActive
Last updated in NPPESOct 12, 2020
Details
- NPI
- 1114533841
- Entity type
- Individual (NPI-1)
- Name
- Rhonda Renae Pettaway Ansier
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 17, 2020
- Certification date
- Oct 12, 2020
- Last updated
- Oct 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 209.020933 | IL | Yes |
Practice location
3700 W 203rd St Ste 110Olympia Fields, IL 60461-1181
Phone 708-679-1890
Mailing address
1860 Paysphere CirChicago, IL 60674-0018
Phone 630-469-9200
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