MEDICARE: MARIA MAGDALENA MACHUCA 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	363LF0000X	Family Nurse Practitioner	APRN001558	NV

General Provider Information

NPI Number	:	1154761880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA MAGDALENA MACHUCA APRN

Provider Business Mailing Address
First Line	:	546 N EASTERN AVE STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-3485
Country	:	US
Telephone Number	:	702-778-7614
Fax Number	:	702-778-7615

Provider Business Practice Location Address
First Line	:	6110 ELTON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107
Country	:	US
Telephone Number	:	702-906-2976
Fax Number	:	702-906-2977

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

Provider Enumeration Date	:	06/26/2013
Last Update Date	:	03/04/2024

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