Healthcare Provider Details

I. General information

NPI: 1275761264
Provider Name (Legal Business Name): REBECCA M MONTE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3039 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4192
US

IV. Provider business mailing address

2545 S BRUCE ST SUITE #8
LAS VEGAS NV
89169-1718
US

V. Phone/Fax

Practice location:
  • Phone: 702-896-6606
  • Fax: 702-896-4221
Mailing address:
  • Phone: 702-733-0744
  • Fax: 702-796-9262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61744
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number001115
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number001115
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number001115
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: