MEDICARE: MRS. EMMA BERNASOR CEMPRON APN

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	APN000965	NV

General Provider Information

NPI Number	:	1073709192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMMA BERNASOR CEMPRON APN

Provider Business Mailing Address
First Line	:	11605 ZAGAROLO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3227
Country	:	US
Telephone Number	:	702-580-7209
Fax Number	:

Provider Business Practice Location Address
First Line	:	11605 ZAGAROLO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3227
Country	:	US
Telephone Number	:	702-580-7209
Fax Number	:

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

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/24/2007

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