MEDICARE: MISS NYMPHA CABATU GARCIA

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	163WH1000X	Hospice Registered Nurse	NV20161219404	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81-2497187	OTHER	NV	LIBERTY CREEK HOSPICE, LLC

General Provider Information

NPI Number	:	1447606835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NYMPHA CABATU GARCIA

Provider Business Mailing Address
First Line	:	2310 PASEO DEL PRADO
Second Line	:	A203
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4357
Country	:	US
Telephone Number	:	702-910-2333
Fax Number	:	702-910-4473

Provider Business Practice Location Address
First Line	:	2310 PASEO DEL PRADO
Second Line	:	A203
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4357
Country	:	US
Telephone Number	:	702-910-2333
Fax Number	:	702-910-4473

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

Provider Enumeration Date	:	05/04/2016
Last Update Date	:	05/11/2016

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