Provider Demographics
NPI:1407827025
Name:ANDRADE, RUI (RN)
Entity Type:Individual
Prefix:MR
First Name:RUI
Middle Name:
Last Name:ANDRADE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:RUI RAMOS
Other - Middle Name:M
Other - Last Name:ANDRADE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3512 LILLOET ST
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-2941
Mailing Address - Country:US
Mailing Address - Phone:801-419-5693
Mailing Address - Fax:
Practice Address - Street 1:4460 HIGHLAND DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-3543
Practice Address - Country:US
Practice Address - Phone:801-273-6366
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5180758-3102163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management