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General NPI Number Information
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NPI Number | 1235966177
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Entity Type | Individual
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Provider Name | LUZELLE KALACAS CAPALLA APRN
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Gender | Female
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Dates
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Enumeration Date | 09/16/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 2839 SAINT ROSE PKWY STE 130
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City | HENDERSON
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State | NV
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Zip | 89052-4849
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Country | US
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Telephone | 702-558-4027
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Fax | 702-558-4028
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Provider Business Mailing Address
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Address Line | 7318 AGAPANTHUS CT
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City | LAS VEGAS
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State | NV
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Zip | 89113-3209
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Country | US
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Telephone | 209-201-5775
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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 | 881130
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License Number State | NV
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