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General NPI Number Information
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NPI Number | 1861899841
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Entity Type | Individual
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Provider Name | BERNADETTE PAYUMO ABREGUNDA PMHNP
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Gender | Female
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 5771 S FORT APACHE RD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89148-5626
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Country | US
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Telephone | 702-951-3400
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Fax | 702-951-3403
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Provider Business Mailing Address
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Address Line | 6355 S BUFFALO DR FL 3
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City | LAS VEGAS
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State | NV
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Zip | 89113-2133
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Country | US
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Telephone | 702-216-3346
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Fax | 702-671-6883
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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 | AP126948
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP126948
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP126948
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 844939
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License Number State | NV
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