Healthcare Provider Details

I. General information

NPI: 1396184438
Provider Name (Legal Business Name): GERALDINE GONZALES DEGUZMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GERALDINE G BENT

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 SAINT ROSE PKWY
HENDERSON NV
89052-3839
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 702-616-5615
  • Fax: 702-616-5120
Mailing address:
  • Phone: 602-406-4786
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN001560
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN001560
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN001560
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: