Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 818426 | NV |
N | 363LP2300X | Nurse Practitioner - Primary Care | 818426 | NV |
NPI | 1013470962 |
---|---|
Provider Name | Aura Cynthia Truelove |
First Address | Las Vegas, NV 89193-8978 |
Second Address | North Las Vegas, NV 89032-2750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2019 |
Last Update Date | 08/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013470962 | (05) | NV |
818426 | STATE LICENSE (01) | NV |