Healthcare Provider Details

I. General information

NPI: 1861696130
Provider Name (Legal Business Name): MYRNA ARROYO PENAFLOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 SHOSHONE CIR
ELKO NV
89801-5072
US

IV. Provider business mailing address

2739 MORNING BREEZE DR
ELKO NV
89801-4767
US

V. Phone/Fax

Practice location:
  • Phone: 775-738-2252
  • Fax:
Mailing address:
  • Phone: 775-738-6665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number09773
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: