Healthcare Provider Details

I. General information

NPI: 1023317740
Provider Name (Legal Business Name): LETICIA CARMEN ZUNIGA RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 W SUNSET RD
HENDERSON NV
89014-6633
US

IV. Provider business mailing address

10186 DEEP GLEN ST
LAS VEGAS NV
89178-6502
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-6700
  • Fax:
Mailing address:
  • Phone: 702-400-6681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN31612
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: