MEDICARE: ADVANCED HEALTHCARE OF NEVADA 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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1952272429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTHCARE OF NEVADA LLC

Provider Business Mailing Address
First Line	:	10308 BIRCH BLUFF LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-8830
Country	:	US
Telephone Number	:	702-338-1403
Fax Number	:

Provider Business Practice Location Address
First Line	:	10308 BIRCH BLUFF LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-8830
Country	:	US
Telephone Number	:	702-338-1403
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARICEL OLAN-CABRERA
Credential	:
Telephone Number	:	702-338-1403

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	09/16/2025

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