MEDICARE: GLORIA GONZALEZ

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	163WH0200X	Home Health Registered Nurse	897912	NV

General Provider Information

NPI Number	:	1326973520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA GONZALEZ

Provider Business Mailing Address
First Line	:	290 FLETCHER FALLS ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-7645
Country	:	US
Telephone Number	:	702-344-7602
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 E WARM SPRINGS RD STE 400
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3144
Country	:	US
Telephone Number	:	702-344-7602
Fax Number	:

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

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/24/2026

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