MEDICARE: STELLA JAVINES RABARA NP

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	APRN002738	NV

General Provider Information

NPI Number	:	1679086706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STELLA JAVINES RABARA NP

Provider Business Mailing Address
First Line	:	9958 CORBRIDGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-3821
Country	:	US
Telephone Number	:	702-677-2654
Fax Number	:

Provider Business Practice Location Address
First Line	:	9958 CORBRIDGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-3821
Country	:	US
Telephone Number	:	702-677-2654
Fax Number	:

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

Provider Enumeration Date	:	11/11/2017
Last Update Date	:	11/11/2017

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