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NPI Code Detail

MEDICARE: MRS. HAZEL TABAO CASTRO APRN-C

MEDICARE: MRS. HAZEL TABAO CASTRO APRN-C
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
1363LF0000XFamily Nurse Practitioner209014354IL
2363L00000XNurse PractitionerAPRN002638NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851833107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HAZEL TABAO CASTRO APRN-C
Provider Business Mailing Address
First Line : 3901 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7537
Country : US
Telephone Number : 702-982-7240
Fax Number : 702-952-5444
Provider Business Practice Location Address
First Line : 3901 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7537
Country : US
Telephone Number : 702-982-7240
Fax Number : 702-952-5444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2016
Last Update Date : 05/31/2024

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Directions to “ MRS. HAZEL TABAO CASTRO APRN-C” Practice Location

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