Healthcare Provider Details

I. General information

NPI: 1851714828
Provider Name (Legal Business Name): ROBERTA GIGEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2014
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 S DECATUR BLVD
LAS VEGAS NV
89107-2936
US

IV. Provider business mailing address

1811 PUERTO WAY
HENDERSON NV
89012-3475
US

V. Phone/Fax

Practice location:
  • Phone: 702-759-1000
  • Fax:
Mailing address:
  • Phone: 702-540-3607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN52717
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: