Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN001882 | NV |
NPI | 1023409505 |
---|---|
Provider Name | Natalie Mason |
First Address | Henderson, NV 89052-5075 |
Second Address | Henderson, NV 89052-5075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2015 |
Last Update Date | 05/02/2015 |