MEDICARE: ZACHARY GUS TUVIDA FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	837371	NV
2	363LF0000X	Family Nurse Practitioner	837371	NV

General Provider Information

NPI Number	:	1033075429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY GUS TUVIDA FNP-C

Provider Business Mailing Address
First Line	:	6695 WOOD THRUSH PL
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89084-2697
Country	:	US
Telephone Number	:	702-533-8128
Fax Number	:

Provider Business Practice Location Address
First Line	:	7495 W AZURE DR STE 209
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4440
Country	:	US
Telephone Number	:	702-407-7700
Fax Number	:	702-407-7016

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	05/02/2026

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