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NPI Code Detail

MEDICARE: NICOLE MARIE BAUTISTA

MEDICARE: NICOLE MARIE BAUTISTA
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
1163W00000XRegistered Nurse897088NV

General Provider Information

NPI Number : 1124955877
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MARIE BAUTISTA
Provider Business Mailing Address
First Line : 3055 SAINT ROSE PKWY
Second Line :
City : HENDERSON
State : NV
Zip : 89052-3889
Country : US
Telephone Number : 702-897-7398
Fax Number :
Provider Business Practice Location Address
First Line : 1516 E TROPICANA AVE STE 238
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-8340
Country : US
Telephone Number : 702-728-0127
Fax Number : 725-910-0825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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Directions to “ NICOLE MARIE BAUTISTA ” Practice Location

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