MEDICARE: BILLY ESCABA LEONARDO APRN

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	APRN002656	NV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN002656	NV

General Provider Information

NPI Number	:	1588174361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BILLY ESCABA LEONARDO APRN

Provider Business Mailing Address
First Line	:	2340 DOLPHIN CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-5319
Country	:	US
Telephone Number	:	702-842-2516
Fax Number	:	253-248-6149

Provider Business Practice Location Address
First Line	:	2340 DOLPHIN CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-5319
Country	:	US
Telephone Number	:	702-842-2516
Fax Number	:	253-248-6149

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

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	02/24/2023

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