Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 14683 | NV |
N | 2080P0214X | Pediatric Pulmonologist | 25MA04841400 | NJ |
NPI | 1609800523 |
---|---|
Provider Name | Evelyn Montalvo-Stanton |
First Address | Las Vegas, NV 89106-4195 |
Second Address | Las Vegas, NV 89106-4195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14683 | LICENSE (01) | NV |
6106501 | (05) | NJ |
CS529657 | CONTROL SUBSTANCE (01) | NV |