Healthcare Provider Details

I. General information

NPI: 1831349653
Provider Name (Legal Business Name): ERWIN DANZER FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 W CHARLESTON BLVD STE 150
LAS VEGAS NV
89102-1998
US

IV. Provider business mailing address

33 LONO AVE STE 240
KAHULUI HI
96732-1632
US

V. Phone/Fax

Practice location:
  • Phone: 702-476-9999
  • Fax: 702-946-1343
Mailing address:
  • Phone: 702-476-9999
  • Fax: 702-946-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1011345
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: