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General NPI Number Information
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NPI Number | 1457343576
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Entity Type | Individual
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Provider Name | RITA MARIA MEJIA-BRAECKEVELT DO
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Gender | Female
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 210 N SANDHILL BLVD
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City | MESQUITE
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State | NV
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Zip | 89027-4789
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Country | US
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Telephone | 702-849-0558
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Fax | 702-346-2147
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Provider Business Mailing Address
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Address Line | 482 BULLDOG DR
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City | MESQUITE
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State | NV
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Zip | 89027-3103
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Country | US
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Telephone |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS12604
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO2522
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License Number State | NV
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