MEDICARE: ELIZABETH DIANA MOURA

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	363L00000X	Nurse Practitioner	831936	NV
2	363LF0000X	Family Nurse Practitioner	831936	NV
3	363LF0000X	Family Nurse Practitioner	778554	CA

General Provider Information

NPI Number	:	1376157628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH DIANA MOURA

Provider Business Mailing Address
First Line	:	8044 FARTHINGS HILL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-3701
Country	:	US
Telephone Number	:	323-803-0072
Fax Number	:

Provider Business Practice Location Address
First Line	:	8044 FARTHINGS HILL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-3701
Country	:	US
Telephone Number	:	323-803-0072
Fax Number	:

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

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	12/11/2025

Similar Medicare Providers

1295727923 — DR. ADELAIDA CANETE ARANAS MD
Practice Location Address:

3701 W CHARLESTON BLVD
LAS VEGAS, NV
89102-1844

Practice Phone: 702-878-5504
Practice Fax: 702-878-8206

1043244767 — MARK OHRINER OD LTD
Practice Location Address:

4675 W FLAMINGO RD
LAS VEGAS, NV
89103-3701

Practice Phone: 702-364-1252
Practice Fax: 702-364-9716

1851305452 — HANGER PROSTHETICS & ORTHOTICS, INC.
Practice Location Address:

4615 W FLAMINGO RD
LAS VEGAS, NV
89103-3701

Practice Phone: 702-366-9681
Practice Fax:

1831288877 — DR. TERESITA LU MELOCOTON M.D.
Practice Location Address:

3701 W CHARLESTON BLVD
LAS VEGAS, NV
89102-1844

Practice Phone: 702-388-4428
Practice Fax: 702-388-4312

1740796994 — DR. LOGAN ASTON PONCE DPT
Practice Location Address:

950 GRIER DR
LAS VEGAS, NV
89119-3701

Practice Phone: 702-352-0200
Practice Fax:

1720584485 — MRS. PHYLLIS GRIFFIN PORCARO
Practice Location Address:

3701 PAUL DE WEERT CT # 89129
LAS VEGAS, NV
89129-5026

Practice Phone: 725-666-4596
Practice Fax:

Directions to “ ELIZABETH DIANA MOURA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.