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NPI Code Detail

MEDICARE: BRENDA CALVILLO

MEDICARE: BRENDA CALVILLO
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
1164W00000XLicensed Practical Nurse17695NV

General Provider Information

NPI Number : 1649727686
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA CALVILLO
Provider Business Mailing Address
First Line : 4040 S EASTERN AVE STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0854
Country : US
Telephone Number : 562-235-9026
Fax Number :
Provider Business Practice Location Address
First Line : 4040 S EASTERN AVE STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0854
Country : US
Telephone Number : 562-235-9026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2016
Last Update Date : 01/11/2024

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Directions to “ BRENDA CALVILLO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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