MEDICARE: MARCIA CASTRO-ROSENBERG APRN

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	363LA2200X	Adult Health Nurse Practitioner	APRN002265	NV

General Provider Information

NPI Number	:	1104279249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA CASTRO-ROSENBERG APRN

Provider Business Mailing Address
First Line	:	2529 DAYSPRING ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7819
Country	:	US
Telephone Number	:	702-449-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	7906 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1990
Country	:	US
Telephone Number	:	702-406-0849
Fax Number	:

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

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	07/13/2016

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