MEDICARE: AFFINITY WOMENS CARE LAS VEGAS

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner

General Provider Information

NPI Number	:	1730645714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY WOMENS CARE LAS VEGAS

Provider Business Mailing Address
First Line	:	7997 W SAHARA AVE # 107
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7948
Country	:	US
Telephone Number	:	702-444-6468
Fax Number	:	702-781-7968

Provider Business Practice Location Address
First Line	:	7997 W SAHARA AVE STE 103
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7901
Country	:	US
Telephone Number	:	702-444-6468
Fax Number	:	702-781-7968

Authorized Official
Title or Position	:	OWNER
Name	:	BECKY GONZSALES
Credential	:	APRN
Telephone Number	:	702-250-9033

Provider Enumeration Date	:	02/14/2019
Last Update Date	:	02/15/2019

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Directions to “AFFINITY WOMENS CARE LAS VEGAS ” Practice Location

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