Provider Demographics
NPI:1003501081
Name:RADOJEVIC, NENAD (RN)
Entity Type:Individual
Prefix:
First Name:NENAD
Middle Name:
Last Name:RADOJEVIC
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 VINE ST STE B
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2596
Mailing Address - Country:US
Mailing Address - Phone:805-237-5544
Mailing Address - Fax:
Practice Address - Street 1:1106 VINE ST STE B
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2596
Practice Address - Country:US
Practice Address - Phone:805-237-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA851132163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse