MEDICARE: NATALIA VIDEVA 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	APRN002844	NV

General Provider Information

NPI Number	:	1962906586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA VIDEVA APRN

Provider Business Mailing Address
First Line	:	3663 E SUNSET RD STE 102C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3246
Country	:	US
Telephone Number	:	702-331-5290
Fax Number	:

Provider Business Practice Location Address
First Line	:	3663 E SUNSET RD STE 102C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3246
Country	:	US
Telephone Number	:	702-331-5290
Fax Number	:

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

Provider Enumeration Date	:	03/20/2018
Last Update Date	:	11/18/2025

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