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General NPI Number Information
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NPI Number | 1760010300
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Entity Type | Individual
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Provider Name | NICOLE KATALINA ANGEL MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1524 PINTO LN FL 3
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City | LAS VEGAS
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State | NV
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Zip | 89106-4195
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Country | US
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Telephone | 702-944-2828
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Fax | 702-944-2852
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Provider Business Mailing Address
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Address Line | 3016 W CHARLESTON BLVD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89102-1973
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Country | US
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Telephone | 702-780-2315
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Fax | 702-895-4014
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 26812
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License Number State | NV
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