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General NPI Number Information
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NPI Number | 1245833151
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Entity Type | Individual
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Provider Name | MICHELE RAMIREZ WIJANGCO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/21/2020
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 4750 W OAKEY BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-1535
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Country | US
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Telephone | 702-877-5199
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Fax |
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Provider Business Mailing Address
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Address Line | 3758 LAS VEGAS BLVD S
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City | LAS VEGAS
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State | NV
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Zip | 89109-4132
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Country | US
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Telephone | 702-262-9028
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 835596
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License Number State | NV
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