Provider Demographics
NPI:1972502607
Name:RAMIREZ, REBECCA RENEE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:RENEE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:RENEE
Other - Last Name:RICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:1305 WONDER WORLD DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7546
Mailing Address - Country:US
Mailing Address - Phone:512-396-7575
Mailing Address - Fax:512-396-7555
Practice Address - Street 1:1305 WONDER WORLD DR
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7546
Practice Address - Country:US
Practice Address - Phone:512-396-7575
Practice Address - Fax:512-396-7555
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX173269164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173269OtherBOARD OF NURSE EXAMINERS