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General NPI Number Information
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NPI Number | 1245214790
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Entity Type | Individual
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Provider Name | MARIA H PETRAS NP-C
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Gender | Female
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 1430 E CALVADA BLVD SUITE 200
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City | PAHRUMP
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State | NV
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Zip | 89048-5824
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Country | US
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Telephone | 775-751-4600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 98978
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City | LAS VEGAS
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State | NV
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Zip | 89193-8978
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Country | US
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Telephone | 702-216-3346
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Fax | 702-671-6883
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | RN036587
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN001079
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License Number State | NV
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