Provider Demographics
NPI:1821431032
Name:CARANDANG, ROSEMARIE E (FNP)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:E
Last Name:CARANDANG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 S DECATUR BLVD STE 25
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-5857
Mailing Address - Country:US
Mailing Address - Phone:725-224-6967
Mailing Address - Fax:833-749-0357
Practice Address - Street 1:4001 S DECATUR BLVD STE 25
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-5857
Practice Address - Country:US
Practice Address - Phone:725-224-6967
Practice Address - Fax:833-749-0357
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV830321363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV66341OtherMEDICARE
NV250009956Medicaid