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General NPI Number Information
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NPI Number | 1629774666
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Entity Type | Individual
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Provider Name | ROBERT ALLEN FARES APRN FNP
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Gender | Male
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 6190 W LAKE MEAD BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89108-2661
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Country | US
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Telephone | 725-293-4224
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Fax | 725-293-5359
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 888-987-1151
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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 | 864097
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License Number State | NV
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