MEDICARE: DR. NICOLETTE A EBERLINE DNP-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	66011	ID

General Provider Information

NPI Number	:	1568061398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLETTE A EBERLINE DNP-FNP

Provider Business Mailing Address
First Line	:	7965 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1991
Country	:	US
Telephone Number	:	725-222-8260
Fax Number	:	855-741-5953

Provider Business Practice Location Address
First Line	:	7965 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1991
Country	:	US
Telephone Number	:	725-222-8260
Fax Number	:	855-741-5953

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

Provider Enumeration Date	:	10/22/2020
Last Update Date	:	12/11/2025

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