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NPI Code Detail

MEDICARE: DR. MARK QUIAMZON DNP, APRN

MEDICARE: DR. MARK QUIAMZON DNP, 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 PractitionerAPRN001485NV

General Provider Information

NPI Number : 1386989978
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK QUIAMZON DNP, APRN
Provider Business Mailing Address
First Line : 9205 W RUSSELL RD STE 240
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1425
Country : US
Telephone Number : 702-499-0589
Fax Number : 702-442-9898
Provider Business Practice Location Address
First Line : 9205 W RUSSELL RD STE 240
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1425
Country : US
Telephone Number : 702-499-0589
Fax Number : 702-442-9898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2012
Last Update Date : 12/20/2017

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