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NPI Code Detail

MEDICARE: MISS ROSETTE SANDRINE MAKON AGNP-C, WCC,PMHNP-BC

MEDICARE: MISS ROSETTE SANDRINE MAKON AGNP-C, WCC,PMHNP-BC
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
1363LG0600XGerontology Nurse Practitioner811435NV
2363LG0600XGerontology Nurse PractitionerAG08170019TX
3363LP0808XPsychiatric/Mental Health Nurse Practitioner811435NV

General Provider Information

NPI Number : 1700302445
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ROSETTE SANDRINE MAKON AGNP-C, WCC,PMHNP-BC
Provider Business Mailing Address
First Line : 510 E MARDON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-1276
Country : US
Telephone Number : 702-637-7535
Fax Number : 702-920-7677
Provider Business Practice Location Address
First Line : 3430 E FLAMINGO RD STE 350
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5067
Country : US
Telephone Number : 702-637-7535
Fax Number : 702-920-7677
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2017
Last Update Date : 06/02/2026

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