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General NPI Number Information
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NPI Number | 1568933984
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Entity Type | Individual
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Provider Name | MRS. GILDA ROSA FERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 12/11/2018
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 6166 S SANDHILL RD STE 112
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City | LAS VEGAS
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State | NV
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Zip | 89120-3216
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Country | US
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Telephone | 725-248-9127
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Fax | 702-495-4475
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Provider Business Mailing Address
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Address Line | 6581 CASA LINDA DR
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City | LAS VEGAS
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State | NV
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Zip | 89103-1015
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Country | US
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Telephone | 786-307-5809
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN11000494
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 818080
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License Number State | NV
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