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General NPI Number Information
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NPI Number | 1053078063
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Entity Type | Individual
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Provider Name | MISS EMILIE PALABASAN
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Gender | Female
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Dates
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Enumeration Date | 11/24/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 5410 LINDERO PL
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City | LAS VEGAS
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State | NV
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Zip | 89119-2713
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Country | US
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Telephone | 702-490-2282
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Fax |
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Provider Business Mailing Address
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Address Line | 3055 S NELLIS BLVD APT 1106
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City | LAS VEGAS
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State | NV
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Zip | 89121-7703
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Country | US
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Telephone | 225-371-1230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | NV20211999944
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License Number State | NV
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