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NPI Code Detail

MEDICARE: MS. ANDRE LESTINA DOUGLAS FNP-BC, PMHNP-BC

MEDICARE: MS. ANDRE LESTINA DOUGLAS FNP-BC, PMHNP-BC
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
1363L00000XNurse Practitioner95020386CA
2363L00000XNurse Practitioner847667NV
3363L00000XNurse Practitioner0024168512VA
4363LP0808XPsychiatric/Mental Health Nurse Practitioner265580AZ

General Provider Information

NPI Number : 1316272388
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDRE LESTINA DOUGLAS FNP-BC, PMHNP-BC
Provider Business Mailing Address
First Line : 1825 E WARM SPRINGS RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4547
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1825 E WARM SPRINGS RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4547
Country : US
Telephone Number : 401-652-9787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2009
Last Update Date : 11/25/2025

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