Provider Demographics
NPI:1366682353
Name:ROMO, RITA
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:ROMO
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:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:NIXON
Mailing Address - State:NV
Mailing Address - Zip Code:89424-0227
Mailing Address - Country:US
Mailing Address - Phone:775-574-1018
Mailing Address - Fax:
Practice Address - Street 1:705 HWY 446
Practice Address - Street 2:
Practice Address - City:NIXON
Practice Address - State:NV
Practice Address - Zip Code:89424
Practice Address - Country:US
Practice Address - Phone:775-574-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLPN14605164W00000X
CAVN246878164X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program