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General NPI Number Information
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NPI Number | 1073700357
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Entity Type | Individual
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Provider Name | NICOLETTA CAMPAGNA
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Gender | Female
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 05/16/2017
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Provider Practice Location Address
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Address Line | 1505 WIGWAM PKWY SUITE 130
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City | HENDERSON
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State | NV
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Zip | 89074-8194
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Country | US
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Telephone | 702-856-1400
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Fax | 702-856-1401
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Provider Business Mailing Address
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Address Line | 2533 LOCHMABEN ST
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City | HENDERSON
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State | NV
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Zip | 89044-1572
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Country | US
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Telephone | 262-914-2477
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 309003520
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN002162
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License Number State | NV
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