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NPI Code Detail

MEDICARE: VANESSA GAIL MIRABBASI NP

MEDICARE: VANESSA GAIL MIRABBASI NP
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
1164W00000XLicensed Practical Nurse309906-031WI
2363LF0000XFamily Nurse PractitionerRN67831NV
3363LF0000XFamily Nurse Practitioner832621NV
4363LF0000XFamily Nurse Practitioner14768-33WI
5363L00000XNurse Practitioner832621NV

General Provider Information

NPI Number : 1932362480
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA GAIL MIRABBASI NP
Provider Business Mailing Address
First Line : 8025 AMIGO ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-1210
Country : US
Telephone Number : 702-380-8300
Fax Number : 702-380-8302
Provider Business Practice Location Address
First Line : 8025 AMIGO ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-1210
Country : US
Telephone Number : 702-380-8300
Fax Number : 702-380-8302
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2008
Last Update Date : 10/06/2025

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