Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 818433 | NV |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 818433 | NV |
N | 363LP2300X | Nurse Practitioner - Primary Care | 818433 | NV |
NPI | 1265998736 |
---|---|
Provider Name | Emerald Sonico |
First Address | Las Vegas, NV 89121-5208 |
Second Address | Las Vegas, NV 89121-5208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2019 |
Last Update Date | 06/12/2020 |