MEDICARE: EILEEN PABLO JUSTO APRN-CNP

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	363LA2100X	Acute Care Nurse Practitioner	818049	NV

General Provider Information

NPI Number	:	1689230500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN PABLO JUSTO APRN-CNP

Provider Business Mailing Address
First Line	:	10239 MONTES VASCOS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-8450
Country	:	US
Telephone Number	:	808-375-6097
Fax Number	:

Provider Business Practice Location Address
First Line	:	6276 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3242
Country	:	US
Telephone Number	:	702-220-5557
Fax Number	:	702-220-5565

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

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	05/16/2019

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