Provider Demographics
NPI:1003499013
Name:SOUZA, ABIGAIL CHRISTINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CHRISTINE
Last Name:SOUZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:CHRISTINE
Other - Last Name:MCCARDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 81345
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89180-1345
Mailing Address - Country:US
Mailing Address - Phone:702-384-5101
Mailing Address - Fax:
Practice Address - Street 1:7201 W LAKE MEAD BLVD STE 112
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8362
Practice Address - Country:US
Practice Address - Phone:702-703-5160
Practice Address - Fax:702-946-5052
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV830142363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily