MEDICARE: SHEILA MARIE FARRALES EVARISTO APRN

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	F07210459	NV
2	363LF0000X	Family Nurse Practitioner	843652	NV

General Provider Information

NPI Number	:	1841969979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA MARIE FARRALES EVARISTO APRN

Provider Business Mailing Address
First Line	:	1720 CYPRESS MANOR DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-7226
Country	:	US
Telephone Number	:	702-568-9033
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 CYPRESS MANOR DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-7226
Country	:	US
Telephone Number	:	702-568-9033
Fax Number	:

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

Provider Enumeration Date	:	09/11/2021
Last Update Date	:	10/18/2023

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