=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376363804
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA RHOTCHIE DELGADO JEREZA MSN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2024
-----------------------------------------------------
Last Update Date | 10/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3087 E WARM SPRINGS RD STE 100
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89120-3754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-461-5773
-----------------------------------------------------
Fax | 775-387-4605
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3087 E WARM SPRINGS RD STE 100
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89120-3754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-461-5773
-----------------------------------------------------
Fax | 775-387-4605
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 883846
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------