=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821957788
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GLORIA PORCIUNCULA RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2026
-----------------------------------------------------
Last Update Date | 01/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6280A S VALLEY VIEW SUITE 120
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-478-9934
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6136 PINE BANKS CT
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89141-8583
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-478-9934
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN70148
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------