MEDICARE: VILMA KEILA CHAVECO LAURENCIO 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
1	363LF0000X	Family Nurse Practitioner	831798	NV

General Provider Information

NPI Number	:	1689422933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VILMA KEILA CHAVECO LAURENCIO APRN

Provider Business Mailing Address
First Line	:	8880 W SUNSET RD STE 320
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5007
Country	:	US
Telephone Number	:	702-476-2287
Fax Number	:	702-718-0393

Provider Business Practice Location Address
First Line	:	2354 E BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-3451
Country	:	US
Telephone Number	:	702-476-2287
Fax Number	:	702-718-0393

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

Provider Enumeration Date	:	05/10/2024
Last Update Date	:	01/26/2026

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Directions to “ VILMA KEILA CHAVECO LAURENCIO APRN” Practice Location

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