MEDICARE: MRS. JANETTE RAQUEPO SERRANO R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	RN29194	NV

General Provider Information

NPI Number	:	1881665131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANETTE RAQUEPO SERRANO R.N.

Provider Business Mailing Address
First Line	:	1725 S RAINBOW BLVD
Second Line	:	SUITE # 21
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2971
Country	:	US
Telephone Number	:	702-384-1427
Fax Number	:	702-384-3635

Provider Business Practice Location Address
First Line	:	1725 S RAINBOW BLVD
Second Line	:	SUITE # 21
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2971
Country	:	US
Telephone Number	:	702-384-1427
Fax Number	:	702-384-3635

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	01/30/2008

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