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NPI Code Detail

MEDICARE: MRS. GILDA ROSA FERNANDEZ

MEDICARE: MRS. GILDA ROSA FERNANDEZ
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
1363LG0600XGerontology Nurse PractitionerAPRN11000494FL
2363LG0600XGerontology Nurse Practitioner818080NV

General Provider Information

NPI Number : 1568933984
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GILDA ROSA FERNANDEZ
Provider Business Mailing Address
First Line : 6581 CASA LINDA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-1015
Country : US
Telephone Number : 786-307-5809
Fax Number :
Provider Business Practice Location Address
First Line : 6166 S SANDHILL RD STE 112
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3216
Country : US
Telephone Number : 725-248-9127
Fax Number : 702-495-4475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2018
Last Update Date : 05/01/2023

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Directions to “ MRS. GILDA ROSA FERNANDEZ ” Practice Location

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