Healthcare Provider Details

I. General information

NPI: 1336560663
Provider Name (Legal Business Name): LOURDES YAPJOCO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 S VALLEY VIEW BLVD
LAS VEGAS NV
89107-4361
US

IV. Provider business mailing address

1889 PAPAGO LN
LAS VEGAS NV
89169-3375
US

V. Phone/Fax

Practice location:
  • Phone: 702-759-0799
  • Fax: 702-759-1436
Mailing address:
  • Phone: 702-249-3981
  • Fax: 702-759-1436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN 30794
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: