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NPI Code Detail

MEDICARE: MARY S BELPORT RN

MEDICARE: MARY S BELPORT RN
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
1163W00000XRegistered NurseRN24102NV
2163WH0200XHome Health Registered NurseRN24102NV

General Provider Information

NPI Number : 1598522419
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY S BELPORT RN
Provider Business Mailing Address
First Line : 5070 TARA AVE UNIT 104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-5464
Country : US
Telephone Number : 702-494-8116
Fax Number :
Provider Business Practice Location Address
First Line : 6045 S FORT APACHE RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5565
Country : US
Telephone Number : 702-948-5095
Fax Number : 702-948-5115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2024
Last Update Date : 03/06/2024

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Directions to “ MARY S BELPORT RN” Practice Location

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