Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN002408 | NV |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN002408 | NV |
NPI | 1316498520 |
---|---|
Provider Name | Trisha Sibayan Tan-Torres |
First Address | Las Vegas, NV 89133-5380 |
Second Address | Las Vegas, NV 89149-0287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 01/05/2019 |