MEDICARE: MT&A CONSULTANCY LLC

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

General Provider Information

NPI Number	:	1467290155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MT&A CONSULTANCY LLC

Provider Business Mailing Address
First Line	:	4614 ERIN GLEN ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7253
Country	:	US
Telephone Number	:	702-789-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	4614 ERIN GLEN ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7253
Country	:	US
Telephone Number	:	702-789-9500
Fax Number	:

Authorized Official
Title or Position	:	NP/PRESIDENT
Name	:	MARIA JUMALON
Credential	:	APRN
Telephone Number	:	702-789-9500

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	07/17/2024

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