Healthcare Provider Details

I. General information

NPI: 1386318780
Provider Name (Legal Business Name): ULRIKE PASTERNAK APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8480 S EASTERN AVE STE F
LAS VEGAS NV
89123-2822
US

IV. Provider business mailing address

PO BOX 401477
LAS VEGAS NV
89140-1477
US

V. Phone/Fax

Practice location:
  • Phone: 702-830-5325
  • Fax: 702-830-4385
Mailing address:
  • Phone: 888-683-2584
  • Fax: 888-683-2567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number845206
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: