Provider Demographics
NPI:1669844072
Name:HEDRIANA, ROLANDO (BSN)
Entity Type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:HEDRIANA
Suffix:
Gender:M
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 HARDIN DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6531
Mailing Address - Country:US
Mailing Address - Phone:702-834-8725
Mailing Address - Fax:
Practice Address - Street 1:2903 HARDIN DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6531
Practice Address - Country:US
Practice Address - Phone:702-834-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-280866163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse