Healthcare Provider Details

I. General information

NPI: 1902722671
Provider Name (Legal Business Name): LISET ZAYAS APRN, AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8695 HAWK CANYON ST
HENDERSON NV
89074-7080
US

IV. Provider business mailing address

8695 HAWK CANYON ST
HENDERSON NV
89074-7080
US

V. Phone/Fax

Practice location:
  • Phone: 702-902-9370
  • Fax:
Mailing address:
  • Phone: 702-902-9370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number903290
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: