Healthcare Provider Details

I. General information

NPI: 1558084806
Provider Name (Legal Business Name): CHERIE MENDOZA DIMAGUILA APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 S MARYLAND PKWY
LAS VEGAS NV
89119-7537
US

IV. Provider business mailing address

7315 S PECOS RD STE 101
LAS VEGAS NV
89120-3768
US

V. Phone/Fax

Practice location:
  • Phone: 702-982-7240
  • Fax: 702-586-7506
Mailing address:
  • Phone: 702-982-7240
  • Fax: 702-586-7506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number856869
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: