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NPI Code Detail

MEDICARE: THOMAS THEROUX FNP-C

MEDICARE: THOMAS THEROUX FNP-C
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
1363L00000XNurse PractitionerAPRN001837NV

General Provider Information

NPI Number : 1518361658
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS THEROUX FNP-C
Provider Business Mailing Address
First Line : 100 PARK VISTA DR UNIT 3014
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-3032
Country : US
Telephone Number : 732-948-1598
Fax Number :
Provider Business Practice Location Address
First Line : 3041 E FLAMINGO RD STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-7447
Country : US
Telephone Number : 702-473-6040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 03/17/2018

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Directions to “ THOMAS THEROUX FNP-C” Practice Location

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