Provider Demographics
NPI:1376770784
Name:RODRIGUEZ, MA. CECILE ROAN (RN)
Entity Type:Individual
Prefix:
First Name:MA. CECILE
Middle Name:ROAN
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 1:2600 S TOWN CENTER DR
Mailing Address - Street 2:APT. # 1127
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-2064
Mailing Address - Country:US
Mailing Address - Phone:702-489-2051
Mailing Address - Fax:
Practice Address - Street 1:2600 S TOWN CENTER DR
Practice Address - Street 2:APT. # 1127
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-2064
Practice Address - Country:US
Practice Address - Phone:702-489-2051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN57330163W00000X
CA704530163W00000X
IL041.367.440163W00000X
AZRN138126163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse