MEDICARE: MARCHELA CAMILE MUNDELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	834566	NV

General Provider Information

NPI Number	:	1013885797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCHELA CAMILE MUNDELL

Provider Business Mailing Address
First Line	:	7201 W LAKE MEAD BLVD STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-8362
Country	:	US
Telephone Number	:	702-703-5160
Fax Number	:

Provider Business Practice Location Address
First Line	:	7201 W LAKE MEAD BLVD STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-8362
Country	:	US
Telephone Number	:	702-703-5160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2025
Last Update Date	:	06/03/2026

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Directions to “ MARCHELA CAMILE MUNDELL ” Practice Location

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