MEDICARE: NENITA T ROXAS 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
1	363LF0000X	Family Nurse Practitioner	830323	NV

General Provider Information

NPI Number	:	1396367900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NENITA T ROXAS APRN

Provider Business Mailing Address
First Line	:	5720 HORNBROOK ST
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-4248
Country	:	US
Telephone Number	:	702-596-4986
Fax Number	:

Provider Business Practice Location Address
First Line	:	9788 GILESPIE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7604
Country	:	US
Telephone Number	:	702-476-9068
Fax Number	:	702-330-0805

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

Provider Enumeration Date	:	05/18/2020
Last Update Date	:	05/18/2020

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Directions to “ NENITA T ROXAS APRN” Practice Location

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