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NPI Code Detail

MEDICARE: ZELLUYAH GAITHO APN GNP PC

MEDICARE: ZELLUYAH GAITHO APN GNP PC
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 PractitionerAPN001242NV
2363L00000XNurse PractitionerAPN001242NV

General Provider Information

NPI Number : 1790129062
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZELLUYAH GAITHO APN GNP PC
Provider Business Mailing Address
First Line : 10161 PARK RUN DR STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-8872
Country : US
Telephone Number : 702-569-5410
Fax Number :
Provider Business Practice Location Address
First Line : 10161 PARK RUN DR STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-8872
Country : US
Telephone Number : 702-569-5410
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : ZELLUYAH GAITHO
Credential :
Telephone Number : 702-569-5410
Provider Enumeration Date : 04/17/2013
Last Update Date : 04/17/2013

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