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General NPI Number Information
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NPI Number | 1790129062
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Entity Type | Organization
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Legal Business Name | ZELLUYAH GAITHO APN GNP PC
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 10161 PARK RUN DR STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89145-8872
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Country | US
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Telephone | 702-569-5410
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Fax |
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Provider Business Mailing Address
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Address Line | 10161 PARK RUN DR STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89145-8872
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Country | US
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Telephone | 702-569-5410
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ZELLUYAH GAITHO
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Credential |
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Telephone | 702-569-5410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APN001242
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN001242
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License Number State | NV
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