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General NPI Number Information
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NPI Number | 1881665131
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Entity Type | Individual
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Provider Name | JANETTE RAQUEPO SERRANO R.N.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 1725 S RAINBOW BLVD SUITE # 21
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City | LAS VEGAS
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State | NV
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Zip | 89146-2971
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Country | US
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Telephone | 702-384-1427
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Fax | 702-384-3635
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Provider Business Mailing Address
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Address Line | 1725 S RAINBOW BLVD SUITE # 21
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City | LAS VEGAS
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State | NV
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Zip | 89146-2971
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Country | US
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Telephone | 702-384-1427
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Fax | 702-384-3635
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN29194
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License Number State | NV
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