MEDICARE: MS. DIVINA GRACIA ROSALES MURAO APRN, FNP-C

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	814055	NV

General Provider Information

NPI Number	:	1396586798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIVINA GRACIA ROSALES MURAO APRN, FNP-C

Provider Business Mailing Address
First Line	:	925 SYCAMORE FALLS ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4524
Country	:	US
Telephone Number	:	702-850-0976
Fax Number	:

Provider Business Practice Location Address
First Line	:	8880 W SUNSET RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5004
Country	:	US
Telephone Number	:	702-850-0976
Fax Number	:

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

Provider Enumeration Date	:	06/03/2024
Last Update Date	:	07/11/2024

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