MEDICARE: JOSUE ORTEGA ROQUE MSN, FNP-C

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	862704	NV

General Provider Information

NPI Number	:	1760337828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSUE ORTEGA ROQUE MSN, FNP-C

Provider Business Mailing Address
First Line	:	8120 WINSLOW AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7348
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 W CRAIG RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0241
Country	:	US
Telephone Number	:	702-790-8000
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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