MEDICARE: LETICIA ANGELICA MONTES 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	821216	NV

General Provider Information

NPI Number	:	1912743956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LETICIA ANGELICA MONTES APRN

Provider Business Mailing Address
First Line	:	946 OPALITE DR
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89705-7128
Country	:	US
Telephone Number	:	775-220-5314
Fax Number	:

Provider Business Practice Location Address
First Line	:	1649 LUCERNE ST STE A
Second Line	:
City	:	MINDEN
State	:	NV
Zip	:	89423-4361
Country	:	US
Telephone Number	:	775-782-1603
Fax Number	:

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

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/08/2024

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