MEDICARE: MR. JOSE ENRIQUE TORRES REYES FNP-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
1	363LF0000X	Family Nurse Practitioner	866766	NV

General Provider Information

NPI Number	:	1831870435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSE ENRIQUE TORRES REYES FNP-BC

Provider Business Mailing Address
First Line	:	6640 SALT BASIN ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-1106
Country	:	US
Telephone Number	:	702-372-4903
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 S RANCHO DR STE F1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3814
Country	:	US
Telephone Number	:	102-474-4454
Fax Number	:

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

Provider Enumeration Date	:	07/26/2023
Last Update Date	:	07/26/2023

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