Provider Demographics
NPI:1881665131
Name:SERRANO, JANETTE RAQUEPO (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:RAQUEPO
Last Name:SERRANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1725 S RAINBOW BLVD
Mailing Address - Street 2:SUITE # 21
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-2971
Mailing Address - Country:US
Mailing Address - Phone:702-384-1427
Mailing Address - Fax:702-384-3635
Practice Address - Street 1:1725 S RAINBOW BLVD
Practice Address - Street 2:SUITE # 21
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-2971
Practice Address - Country:US
Practice Address - Phone:702-384-1427
Practice Address - Fax:702-384-3635
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN29194163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV297118Medicare Oscar/Certification