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General NPI Number Information
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NPI Number | 1770977407
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Entity Type | Individual
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Provider Name | CARLY ROSE NELSON APRN
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Gender | Female
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 2011 PINTO LN STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89106-4007
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Country | US
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Telephone | 702-382-3200
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Fax | 702-382-3575
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Provider Business Mailing Address
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Address Line | 2011 PINTO LN STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89106-4007
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Country | US
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Telephone | 702-382-3200
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Fax | 702-382-3575
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN001911
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 323867
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License Number State | AZ
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