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NPI Code Detail

MEDICARE: BECKY R GONZALES APN

MEDICARE: BECKY R GONZALES APN
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
1363LX0001XObstetrics & Gynecology Nurse PractitionerAPN000810NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457552648
Entity Type Code : Individual
Provider Name (Legal Business Name) : BECKY R GONZALES APN
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-877-5199
Fax Number :
Provider Business Practice Location Address
First Line : 5761 S FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5506
Country : US
Telephone Number : 702-341-6610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 03/24/2026

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Directions to “ BECKY R GONZALES APN” Practice Location

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