MEDICARE: NURSE PRACTITIONERS STAFFING CORP LLC

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	2406	NV

General Provider Information

NPI Number	:	1659892123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURSE PRACTITIONERS STAFFING CORP LLC

Provider Business Mailing Address
First Line	:	5693 S JONES BLVD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1969
Country	:	US
Telephone Number	:	714-856-4414
Fax Number	:	855-641-8906

Provider Business Practice Location Address
First Line	:	5693 S JONES BLVD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1969
Country	:	US
Telephone Number	:	714-856-4414
Fax Number	:	855-641-8906

Authorized Official
Title or Position	:	PROVIDER
Name	:	RONNIE M VALLE
Credential	:	NP
Telephone Number	:	714-856-4414

Provider Enumeration Date	:	07/05/2017
Last Update Date	:	07/21/2022

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