Healthcare Provider Details

I. General information

NPI: 1730522764
Provider Name (Legal Business Name): ANGELINA D BUCU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8480 S EASTERN AVE STE F
LAS VEGAS NV
89123-2822
US

IV. Provider business mailing address

8480 S EASTERN AVE STE F
LAS VEGAS NV
89123-2822
US

V. Phone/Fax

Practice location:
  • Phone: 702-830-5325
  • Fax: 702-830-4835
Mailing address:
  • Phone: 702-830-5325
  • Fax: 702-830-4835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22776
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number825676
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: