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General NPI Number Information
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NPI Number | 1669269924
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Entity Type | Organization
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Legal Business Name | ETERNA MEDICAL GROUP LLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 2801 S VALLEY VIEW BLVD STE 13
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City | LAS VEGAS
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State | NV
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Zip | 89102-0116
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Country | US
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Telephone | 832-898-6978
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Fax | 832-898-6978
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Provider Business Mailing Address
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Address Line | 2801 S VALLEY VIEW BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-0116
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Country | US
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Telephone | 832-898-6978
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | YALENA LEZCANO RAMOS
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Credential | YALENA LEZCANO APRN
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Telephone | 832-898-6978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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