Provider Demographics
NPI:1326696980
Name:RODRIGUEZ, SERENA LUNA (RN)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:LUNA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 ABAMILLO CT
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-4387
Mailing Address - Country:US
Mailing Address - Phone:979-451-3616
Mailing Address - Fax:
Practice Address - Street 1:313 ABAMILLO CT
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-4387
Practice Address - Country:US
Practice Address - Phone:979-451-3616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX959366163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse