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General NPI Number Information
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NPI Number | 1124593173
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Entity Type | Individual
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Provider Name | TERESA PATAWARAN BUCO REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 801 S RANCHO DR STE E7
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City | LAS VEGAS
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State | NV
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Zip | 89106-3812
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Country | US
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Telephone | 702-478-5133
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Fax | 702-478-5401
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Provider Business Mailing Address
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Address Line | 1651 AMERICAN PACIFIC DR APT 7207
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City | HENDERSON
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State | NV
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Zip | 89074-7613
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Country | US
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Telephone | 702-587-5833
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95165109
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 811511
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License Number State | NV
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