Healthcare Provider Details

I. General information

NPI: 1013693597
Provider Name (Legal Business Name): MORGAN NAJARRO RDN/LD, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 W CHARLESTON BLVD STE 110
LAS VEGAS NV
89117-9095
US

IV. Provider business mailing address

3265 EL CAMINO RD
LAS VEGAS NV
89146-6623
US

V. Phone/Fax

Practice location:
  • Phone: 702-764-9290
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number39756-DI-0
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-311728
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: