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NPI Code Detail

MEDICARE: ADVANCED PRACTITIONER LLC

MEDICARE: ADVANCED PRACTITIONER LLC
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
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1922721406
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED PRACTITIONER LLC
Provider Business Mailing Address
First Line : 6843 W TROPICANA AVE STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4923
Country : US
Telephone Number : 702-888-1113
Fax Number : 888-498-3867
Provider Business Practice Location Address
First Line : 6843 W TROPICANA AVE STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4923
Country : US
Telephone Number : 510-590-2779
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : MARK JOEL CULANAG
Credential : MSN, APRN, FNP-C
Telephone Number : 510-590-2779
Provider Enumeration Date : 09/21/2022
Last Update Date : 06/17/2026

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Directions to “ADVANCED PRACTITIONER LLC ” Practice Location

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