Healthcare Provider Details

I. General information

NPI: 1932557915
Provider Name (Legal Business Name): LAUREN ASHLEY RIVERA ESCAMIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN ASHLEY CASCOLAN

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 06/18/2023
Certification Date: 06/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6990 SMOKE RANCH RD
LAS VEGAS NV
89128-3119
US

IV. Provider business mailing address

2809 W CHARLESTON BLVD STE. 150
LAS VEGAS NV
89102-1998
US

V. Phone/Fax

Practice location:
  • Phone: 702-476-9999
  • Fax: 702-946-1343
Mailing address:
  • Phone: 702-476-9999
  • Fax: 702-946-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN701375
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: