Provider Demographics
NPI:1568233039
Name:RAWLS, RONALD ROSS
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ROSS
Last Name:RAWLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 CEDAR MEADOWS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4921
Mailing Address - Country:US
Mailing Address - Phone:725-724-7768
Mailing Address - Fax:
Practice Address - Street 1:2472 CEDAR MEADOWS ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4921
Practice Address - Country:US
Practice Address - Phone:725-724-7768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant