Healthcare Provider Details

I. General information

NPI: 1912233446
Provider Name (Legal Business Name): MICHELLE KATHLYNE CUEVAS DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2009
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41750 RANCHO LAS PALMAS DR STE M3
RANCHO MIRAGE CA
92270-5511
US

IV. Provider business mailing address

40960 CALIFORNIA OAKS RD # 264
MURRIETA CA
92562-5747
US

V. Phone/Fax

Practice location:
  • Phone: 760-895-4292
  • Fax:
Mailing address:
  • Phone: 951-290-2936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number21868
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: