MEDICARE: SHEILA VILLACRUCIS

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
1	363LF0000X	Family Nurse Practitioner	863509	NV

General Provider Information

NPI Number	:	1659083392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA VILLACRUCIS

Provider Business Mailing Address
First Line	:	9280 W SUNSET RD STE 410
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4862
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5957 GORDON CREEK AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-7113
Country	:	US
Telephone Number	:	702-460-0651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2022
Last Update Date	:	08/02/2024

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Directions to “ SHEILA VILLACRUCIS ” Practice Location

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