Healthcare Provider Details

I. General information

NPI: 1083579338
Provider Name (Legal Business Name): MARIA ROWENA MEDINA DE GUZMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 S RAINBOW BLVD STE 102
LAS VEGAS NV
89146-5191
US

IV. Provider business mailing address

2626 S RAINBOW BLVD STE 102
LAS VEGAS NV
89146-5191
US

V. Phone/Fax

Practice location:
  • Phone: 702-845-7292
  • Fax: 702-209-0970
Mailing address:
  • Phone: 702-845-7292
  • Fax: 702-209-0970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number859392
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: