Provider Demographics
NPI:1093916603
Name:VAZQUEZ, EVELYN DELA REA (APN)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:DELA REA
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:2316 STORKSPUR WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5918
Mailing Address - Country:US
Mailing Address - Phone:702-242-2032
Mailing Address - Fax:702-242-2032
Practice Address - Street 1:1800 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2329
Practice Address - Country:US
Practice Address - Phone:702-383-2443
Practice Address - Fax:702-383-6224
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV00232363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care