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NPI Code Detail

MEDICARE: NATHALIE ISLENA RIVAS APRN

MEDICARE: NATHALIE ISLENA RIVAS 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
1363LF0000XFamily Nurse Practitioner889830NV

General Provider Information

NPI Number : 1174316061
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHALIE ISLENA RIVAS APRN
Provider Business Mailing Address
First Line : 10925 S EASTERN AVE STE 120
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5214
Country : US
Telephone Number : 702-992-3688
Fax Number :
Provider Business Practice Location Address
First Line : 1707 W CHARLESTON BLVD STE 160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2354
Country : US
Telephone Number : 702-671-5150
Fax Number : 702-384-6493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2025
Last Update Date : 01/21/2026

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