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NPI Code Detail

MEDICARE: MARVI SOCORRO MACAHILIG NAVARRA APRN

MEDICARE: MARVI SOCORRO MACAHILIG NAVARRA APRN
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
1163WG0000XGeneral Practice Registered NurseAPN001450NV
2363LF0000XFamily Nurse PractitionerAPRN001450NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1APRN001450OTHERNVNEVADA STATE BOARD OF NURSING
21659617538OTHERNV1659617538

General Provider Information

NPI Number : 1659617538
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARVI SOCORRO MACAHILIG NAVARRA APRN
Provider Business Mailing Address
First Line : 7285 S DURANGO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2098
Country : US
Telephone Number : 702-489-3580
Fax Number : 702-489-3580
Provider Business Practice Location Address
First Line : 7285 S DURANGO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2098
Country : US
Telephone Number : 702-407-2933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2012
Last Update Date : 03/17/2018

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