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General NPI Number Information
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NPI Number | 1689230500
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Entity Type | Individual
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Provider Name | EILEEN PABLO JUSTO APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 6276 S RAINBOW BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89118-3242
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Country | US
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Telephone | 702-220-5557
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Fax | 702-220-5565
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Provider Business Mailing Address
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Address Line | 10239 MONTES VASCOS DR
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City | LAS VEGAS
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State | NV
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Zip | 89178-8450
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Country | US
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Telephone | 808-375-6097
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 818049
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License Number State | NV
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