Healthcare Provider Details

I. General information

NPI: 1942310420
Provider Name (Legal Business Name): CHARLOTTE L DHUDSHIA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3196 S MARYLAND PKWY SUITE 217
LAS VEGAS NV
89109-2305
US

IV. Provider business mailing address

288 IVYWOOD CT
LAS VEGAS NV
89183-4559
US

V. Phone/Fax

Practice location:
  • Phone: 702-733-4944
  • Fax: 702-733-6507
Mailing address:
  • Phone: 702-565-0545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAPN000806
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPN000806
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: