Healthcare Provider Details

I. General information

NPI: 1033302328
Provider Name (Legal Business Name): IRENE MOSQUEDA BENLIRO DNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11201 S EASTERN AVE STE 110
HENDERSON NV
89052-6200
US

IV. Provider business mailing address

11201 S EASTERN AVE STE 110
HENDERSON NV
89052-6200
US

V. Phone/Fax

Practice location:
  • Phone: 702-534-4244
  • Fax: 725-605-6792
Mailing address:
  • Phone: 702-534-4244
  • Fax: 725-605-6792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN44413
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberAPN700372
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN001014
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: