MEDICARE: EDELMIRA RENTERIA SANTACRUZ

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	9599-PCS-6	NV

General Provider Information

NPI Number	:	1356298723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDELMIRA RENTERIA SANTACRUZ

Provider Business Mailing Address
First Line	:	4768 SUMMERHILL RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5633
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 E SAHARA AVE STE 4A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3495
Country	:	US
Telephone Number	:	702-769-0584
Fax Number	:

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

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “ EDELMIRA RENTERIA SANTACRUZ ” Practice Location

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