MEDICARE: ROSA ANIJELICA DUNN APRN

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	363L00000X	Nurse Practitioner	881958	NV

General Provider Information

NPI Number	:	1508607029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSA ANIJELICA DUNN APRN

Provider Business Mailing Address
First Line	:	508 PUENTA DEL REY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-2011
Country	:	US
Telephone Number	:	702-979-8881
Fax Number	:

Provider Business Practice Location Address
First Line	:	7140 SMOKE RANCH RD STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3157
Country	:	US
Telephone Number	:	702-320-8111
Fax Number	:	702-320-8112

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

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	01/30/2026

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