Healthcare Provider Details

I. General information

NPI: 1003721135
Provider Name (Legal Business Name): NINA BARRETTO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2813 TAHITI GRAPE WAY UNIT 2
LAS VEGAS NV
89183-6135
US

IV. Provider business mailing address

2813 TAHITI GRAPE WAY UNIT 2
LAS VEGAS NV
89183-6135
US

V. Phone/Fax

Practice location:
  • Phone: 702-588-3637
  • Fax:
Mailing address:
  • Phone: 702-588-3637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: