MEDICARE: SUSANA MUNETON

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	172V00000X	Community Health Worker	CHW1-6173	NV

General Provider Information

NPI Number	:	1326922576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSANA MUNETON

Provider Business Mailing Address
First Line	:	3325 RESEARCH WAY
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89706-7913
Country	:	US
Telephone Number	:	702-220-9902
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 N MAIN ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-8910
Country	:	US
Telephone Number	:	702-563-4657
Fax Number	:	702-636-5448

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

Provider Enumeration Date	:	08/01/2025
Last Update Date	:	08/06/2025

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Directions to “ SUSANA MUNETON ” Practice Location

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