Healthcare Provider Details

I. General information

NPI: 1437477726
Provider Name (Legal Business Name): SARAH KATHLEEN CERVANTES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4275 BURNHAM AVE STE 255
LAS VEGAS NV
89119-8204
US

IV. Provider business mailing address

PO BOX 26299
LAS VEGAS NV
89126-0299
US

V. Phone/Fax

Practice location:
  • Phone: 702-380-1060
  • Fax: 702-380-1081
Mailing address:
  • Phone: 702-893-3333
  • Fax: 702-893-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License NumberRN57506
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: