Provider Demographics
NPI:1760198121
Name:MORENO-JUAREZ, VANESSA RUBI
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:RUBI
Last Name:MORENO-JUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 MANCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1920
Mailing Address - Country:US
Mailing Address - Phone:775-636-3020
Mailing Address - Fax:
Practice Address - Street 1:1715 MANCHESTER WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-1920
Practice Address - Country:US
Practice Address - Phone:775-636-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist