Healthcare Provider Details

I. General information

NPI: 1881483972
Provider Name (Legal Business Name): RAQUEL OLORES WELSH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 GRASSWREN DR
NORTH LAS VEGAS NV
89084-2818
US

IV. Provider business mailing address

3009 GRASSWREN DR
NORTH LAS VEGAS NV
89084-2818
US

V. Phone/Fax

Practice location:
  • Phone: 702-340-0939
  • Fax:
Mailing address:
  • Phone: 702-340-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN70199
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: