Provider Demographics
NPI:1659429207
Name:PREDA, RAZVAN N (RN-BSN)
Entity Type:Individual
Prefix:MR
First Name:RAZVAN
Middle Name:N
Last Name:PREDA
Suffix:
Gender:M
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 DIETZ PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-3220
Mailing Address - Country:US
Mailing Address - Phone:505-341-0892
Mailing Address - Fax:
Practice Address - Street 1:2600 MARBLE AVE. NE
Practice Address - Street 2:MSC10 5640
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-5426
Practice Address - Country:US
Practice Address - Phone:505-272-2826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR54944163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult