Provider Demographics
NPI:1366327181
Name:HEANUE-RODRIGUEZ, NOE MORENO (N/A)
Entity type:Individual
Prefix:MR
First Name:NOE
Middle Name:MORENO
Last Name:HEANUE-RODRIGUEZ
Suffix:
Gender:M
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15670 FOUNTAIN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-2170
Mailing Address - Country:US
Mailing Address - Phone:402-630-0346
Mailing Address - Fax:
Practice Address - Street 1:1401 E GOLD COAST RD STE 430
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-5748
Practice Address - Country:US
Practice Address - Phone:402-331-3073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty