Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 811112 | NV |
NPI | 1083190789 |
---|---|
Provider Name | Vitalina Adamchevska |
First Address | Las Vegas, NV 89141-7101 |
Second Address | Henderson, NV 89052-4379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2018 |
Last Update Date | 11/10/2020 |