Healthcare Provider Details

I. General information

NPI: 1457773772
Provider Name (Legal Business Name): STEPHANIE JEANETTE ROMANO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 S DECATUR BLVD
LAS VEGAS NV
89107-2936
US

IV. Provider business mailing address

280 S DECATUR BLVD
LAS VEGAS NV
89107-2936
US

V. Phone/Fax

Practice location:
  • Phone: 702-759-0792
  • Fax:
Mailing address:
  • Phone: 702-759-0792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN61773
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTAPRN701840
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: