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NPI Code Detail

MEDICARE: JENNIFER BUITRAGO CPNP

MEDICARE: JENNIFER BUITRAGO CPNP
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
1363LP0200XPediatric Nurse PractitionerAPN000838NV
2363LP0200XPediatric Nurse Practitioner67914CA
3363LP0200XPediatric Nurse Practitioner536283CA
4363L00000XNurse PractitionerAPRN000838NV
5363LP0200XPediatric Nurse Practitioner12738CA
6363LP0200XPediatric Nurse PractitionerRN47814NV
7363LP0200XPediatric Nurse PractitionerAPRN000838NV

General Provider Information

NPI Number : 1073529822
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BUITRAGO CPNP
Provider Business Mailing Address
First Line : 10170 W TROPICANA AVE # 156-252
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-8465
Country : US
Telephone Number : 702-732-1493
Fax Number : 702-732-1080
Provider Business Practice Location Address
First Line : 1 BREAKTHROUGH WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-3011
Country : US
Telephone Number : 702-732-1493
Fax Number : 702-732-1080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 11/11/2021

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Directions to “ JENNIFER BUITRAGO CPNP” Practice Location

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