Provider Demographics
NPI:1477869071
Name:ROMAN-MORALES, JANETTE BRUNILDA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:BRUNILDA
Last Name:ROMAN-MORALES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR653 BO BARRANCA
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-878-9112
Mailing Address - Fax:
Practice Address - Street 1:CARR 129 ASSMCA
Practice Address - Street 2:ESTACION COTTO 9550
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-3552
Practice Address - Fax:787-879-8633
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR020750164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse