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General NPI Number Information
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NPI Number | 1710507868
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Entity Type | Individual
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Provider Name | ROMMEL LACSAMANA APRN
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Gender | Male
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Dates
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Enumeration Date | 04/19/2020
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Last Update Date | 04/19/2020
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Provider Practice Location Address
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Address Line | 10410 S EASTERN AVE STE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4196
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Country | US
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Telephone | 702-914-7150
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Fax |
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Provider Business Mailing Address
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Address Line | 2740 BLAIRGOWRIE DR
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City | HENDERSON
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State | NV
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Zip | 89044-0211
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Country | US
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Telephone | 702-480-3504
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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 | 828868
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License Number State | NV
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