MEDICARE: SHARON PEDROCHE RUIZ FNP

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	APRN002916	NV

General Provider Information

NPI Number	:	1669964284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON PEDROCHE RUIZ FNP

Provider Business Mailing Address
First Line	:	8210 RIVER RIM CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-6114
Country	:	US
Telephone Number	:	702-423-5215
Fax Number	:

Provider Business Practice Location Address
First Line	:	9111 W RUSSELL RD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1245
Country	:	US
Telephone Number	:	702-312-3333
Fax Number	:

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

Provider Enumeration Date	:	05/30/2018
Last Update Date	:	10/11/2023

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