MEDICARE: BHEN NASOL FNP

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	363LF0000X	Family Nurse Practitioner	868850	NV

General Provider Information

NPI Number	:	1396596052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHEN NASOL FNP

Provider Business Mailing Address
First Line	:	601 EL LORO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-6031
Country	:	US
Telephone Number	:	702-465-3823
Fax Number	:

Provider Business Practice Location Address
First Line	:	7373 PEAK DR STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9004
Country	:	US
Telephone Number	:	725-780-4351
Fax Number	:	725-780-4339

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

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	05/06/2025

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Directions to “ BHEN NASOL FNP” Practice Location

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