Healthcare Provider Details

I. General information

NPI: 1962883553
Provider Name (Legal Business Name): MA VICTORIA MANLAPAS ESCARDA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8612 COPPER KNOLL AVE
LAS VEGAS NV
89129-7649
US

IV. Provider business mailing address

8612 COPPER KNOLL AVE
LAS VEGAS NV
89129-7649
US

V. Phone/Fax

Practice location:
  • Phone: 132-333-8610
  • Fax:
Mailing address:
  • Phone: 132-333-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberTAPRN701135
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN001943
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: