Provider Demographics
NPI:1083305486
Name:DURAN FELIPE, ELISA ZAMIRA
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:ZAMIRA
Last Name:DURAN FELIPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18600 WEDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3036
Mailing Address - Country:US
Mailing Address - Phone:775-784-4046
Mailing Address - Fax:
Practice Address - Street 1:18600 WEDGE PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3036
Practice Address - Country:US
Practice Address - Phone:775-784-4046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program