Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN002192 | NV |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 95003466 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 95003466 | CA |
NPI | 1073987236 |
---|---|
Provider Name | Imelda Aura S. Colinares |
First Address | Henderson, NV 89052-2729 |
Second Address | Henderson, NV 89052-2729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2015 |
Last Update Date | 30/12/2021 |