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NPI Code Detail

MEDICARE: RAPHAELA CARRILLO

MEDICARE:   RAPHAELA  CARRILLO
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
1163WH0200XHome Health Registered Nurse893817NV

General Provider Information

NPI Number : 1396696704
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAPHAELA CARRILLO
Provider Business Mailing Address
First Line : 1988 DRY FALLS ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89142-1244
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1988 DRY FALLS ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89142-1244
Country : US
Telephone Number : 702-755-8486
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2026
Last Update Date : 02/04/2026

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Directions to “ RAPHAELA CARRILLO ” Practice Location

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