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NPI Code Detail

MEDICARE: VIVENCIO C NAVARRO MSN, ANP-BC

MEDICARE: VIVENCIO C NAVARRO MSN, ANP-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
1363L00000XNurse PractitionerAPN001049NV

General Provider Information

NPI Number : 1750532131
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVENCIO C NAVARRO MSN, ANP-BC
Provider Business Mailing Address
First Line : PO BOX 81345
Second Line :
City : LAS VEGAS
State : NV
Zip : 89180-1345
Country : US
Telephone Number : 702-384-5101
Fax Number : 702-382-5675
Provider Business Practice Location Address
First Line : 2000 WELLNESS WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4113
Country : US
Telephone Number : 702-384-5101
Fax Number : 702-387-0104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2008
Last Update Date : 03/24/2026

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