MEDICARE: VICTORIA MONRAE ALLEN FNP-BC

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	830877	NV

General Provider Information

NPI Number	:	1447852413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA MONRAE ALLEN FNP-BC

Provider Business Mailing Address
First Line	:	3550 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5867
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2830 FREMONT ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-2206
Country	:	US
Telephone Number	:	702-759-1000
Fax Number	:

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

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	12/15/2023

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