MEDICARE: MS. DANIELLE MOULD FNP

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	839388	NV

General Provider Information

NPI Number	:	1497591358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANIELLE MOULD FNP

Provider Business Mailing Address
First Line	:	8880 W SUNSET RD STE 320
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5007
Country	:	US
Telephone Number	:	702-529-2217
Fax Number	:	725-220-6389

Provider Business Practice Location Address
First Line	:	8880 W SUNSET RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5007
Country	:	US
Telephone Number	:	725-200-3232
Fax Number	:	702-476-2035

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

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	10/16/2025

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