Healthcare Provider Details

I. General information

NPI: 1417547746
Provider Name (Legal Business Name): MALAINA SPAIN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 N TENAYA WAY
LAS VEGAS NV
89128-0443
US

IV. Provider business mailing address

7005 BEAUTIFUL BELLE ST
NORTH LAS VEGAS NV
89086-1714
US

V. Phone/Fax

Practice location:
  • Phone: 702-233-4950
  • Fax:
Mailing address:
  • Phone: 414-595-1630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number837305
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP70031775
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number318409
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16664-33
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95034598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: