Healthcare Provider Details

I. General information

NPI: 1912881764
Provider Name (Legal Business Name): GABRIELA ESTRADA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 E LAKE MEAD BLVD STE 300
N LAS VEGAS NV
89030-7193
US

IV. Provider business mailing address

1815 E LAKE MEAD BLVD STE 300
NORTH LAS VEGAS NV
89030-7193
US

V. Phone/Fax

Practice location:
  • Phone: 702-960-4150
  • Fax: 702-960-4154
Mailing address:
  • Phone: 702-960-4150
  • Fax: 702-960-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number890235
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: