Provider Demographics
NPI:1295347946
Name:LOUICA, ROMEDRUDE (FNP-C)
Entity type:Individual
Prefix:
First Name:ROMEDRUDE
Middle Name:
Last Name:LOUICA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ROMEDRUDE
Other - Middle Name:
Other - Last Name:POMAPHIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2329
Mailing Address - Country:US
Mailing Address - Phone:520-476-3503
Mailing Address - Fax:
Practice Address - Street 1:11518 N FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-8994
Practice Address - Country:US
Practice Address - Phone:928-342-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ265806363L00000X, 363LF0000X
FL11008660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner