Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 834829 | NV |
N | 363LP0200X | Nurse Practitioner - Pediatrics | R34963 | NM |
NPI | 1023262409 |
---|---|
Provider Name | Carmela Brienza |
First Address | Las Vegas, NV 89102-1973 |
Second Address | Las Vegas, NV 89106-4195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2008 |
Last Update Date | 26/10/2021 |