Provider Demographics
NPI:1033644687
Name:ACEVEDO, ADRIANA (RNFA)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 RUE BEAUREGARD
Mailing Address - Street 2:STE 202
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3251
Mailing Address - Country:US
Mailing Address - Phone:661-477-2808
Mailing Address - Fax:
Practice Address - Street 1:201 RUE BEAUREGARD
Practice Address - Street 2:STE 202
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3251
Practice Address - Country:US
Practice Address - Phone:661-477-2808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN140001163WR0006X
TX917042163WR0006X
CA789784163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant