MEDICARE: NADIASLY M SANTILLANO CUESTA APRN-CNP

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	163W00000X	Registered Nurse	RN92845	NV
2	363LF0000X	Family Nurse Practitioner	831335	NV

General Provider Information

NPI Number	:	1134595259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIASLY M SANTILLANO CUESTA APRN-CNP

Provider Business Mailing Address
First Line	:	413 FINCH RIDGE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-9069
Country	:	US
Telephone Number	:	713-478-2227
Fax Number	:

Provider Business Practice Location Address
First Line	:	413 FINCH RIDGE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-9069
Country	:	US
Telephone Number	:	713-478-2227
Fax Number	:

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

Provider Enumeration Date	:	08/12/2015
Last Update Date	:	09/13/2023

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