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General NPI Number Information
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NPI Number | 1588254122
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Entity Type | Individual
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Provider Name | MA CRISTINA MENESES VICERAL APRN-FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 2480 E TOMPKINS AVE STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89121-5466
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Country | US
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Telephone | 725-724-2005
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Fax | 877-418-8013
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Provider Business Mailing Address
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Address Line | 2480 E TOMPKINS AVE STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89121-7394
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Country | US
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Telephone | 725-724-2005
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Fax | 877-418-8013
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 836771
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 836771
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | PMH12240031
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 836771
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License Number State | NV
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