MEDICARE: ELSA LIM LINATOC RN

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	163WA2000X	Administrator Registered Nurse	821972	NV

General Provider Information

NPI Number	:	1073397477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSA LIM LINATOC RN

Provider Business Mailing Address
First Line	:	7764 ALOLA SPRINGS LN
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-3819
Country	:	US
Telephone Number	:	702-787-4144
Fax Number	:

Provider Business Practice Location Address
First Line	:	4055 SPENCER ST STE 217
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5251
Country	:	US
Telephone Number	:	702-787-4144
Fax Number	:

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

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	08/24/2023

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