MEDICARE: MR. HOMER CABRERA TUAZON APRN, FNPC

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	001431	NV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN001431	NV
3	363LF0000X	Family Nurse Practitioner	APRN001431	NV

General Provider Information

NPI Number	:	1861817934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HOMER CABRERA TUAZON APRN, FNPC

Provider Business Mailing Address
First Line	:	PO BOX 400546
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89140-0546
Country	:	US
Telephone Number	:	702-417-3865
Fax Number	:	702-444-7898

Provider Business Practice Location Address
First Line	:	3130 S RAINBOW BLVD STE 301
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6212
Country	:	US
Telephone Number	:	702-444-7744
Fax Number	:	702-444-7898

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

Provider Enumeration Date	:	02/26/2014
Last Update Date	:	02/10/2025

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