Healthcare Provider Details

I. General information

NPI: 1780512558
Provider Name (Legal Business Name): CAROLINE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2354 E BONANZA RD
LAS VEGAS NV
89101-3451
US

IV. Provider business mailing address

12213 LOST TREASURE AVE
LAS VEGAS NV
89138-5009
US

V. Phone/Fax

Practice location:
  • Phone: 702-476-2287
  • Fax:
Mailing address:
  • Phone: 480-848-2895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number842447
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: