Healthcare Provider Details

I. General information

NPI: 1326811944
Provider Name (Legal Business Name): CAMELLA MARISSE NARAVAL LAU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 CALAMUS PALM PL
HENDERSON NV
89011-2645
US

IV. Provider business mailing address

727 CALAMUS PALM PL
HENDERSON NV
89011-2645
US

V. Phone/Fax

Practice location:
  • Phone: 702-902-7486
  • Fax:
Mailing address:
  • Phone: 702-902-7486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number810422
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number810422
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: