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NPI Code Detail

MEDICARE: MA CRISTINA MENESES VICERAL APRN-FNP-C

MEDICARE: MA CRISTINA MENESES VICERAL APRN-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
1363LF0000XFamily Nurse Practitioner836771NV
2363LA2200XAdult Health Nurse Practitioner836771NV
3363L00000XNurse Practitioner836771NV
4363LP0808XPsychiatric/Mental Health Nurse PractitionerPMH12240031NV

General Provider Information

NPI Number : 1588254122
Entity Type Code : Individual
Provider Name (Legal Business Name) : MA CRISTINA MENESES VICERAL APRN-FNP-C
Provider Business Mailing Address
First Line : 2480 E TOMPKINS AVE STE 201
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-7394
Country : US
Telephone Number : 725-724-2005
Fax Number : 877-418-8013
Provider Business Practice Location Address
First Line : 2480 E TOMPKINS AVE STE 201
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-7394
Country : US
Telephone Number : 725-724-2005
Fax Number : 877-418-8013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2021
Last Update Date : 03/06/2026

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Directions to “ MA CRISTINA MENESES VICERAL APRN-FNP-C” Practice Location

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