Provider Demographics
NPI:1114445756
Name:EVANGELISTA, ESTRELLA P (DNP, MED, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ESTRELLA
Middle Name:P
Last Name:EVANGELISTA
Suffix:
Gender:F
Credentials:DNP, MED, PMHNP-BC
Other - Prefix:
Other - First Name:ESTRELLA
Other - Middle Name:
Other - Last Name:EVANGELISTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, DNP, PMHNP-BC
Mailing Address - Street 1:6605 GRAND MONTECITO PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0210
Mailing Address - Country:US
Mailing Address - Phone:702-401-8794
Mailing Address - Fax:
Practice Address - Street 1:6605 GRAND MONTECITO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0210
Practice Address - Country:US
Practice Address - Phone:702-401-8794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV171400000X, 171400000X
NV852512363LP0808X, 363LP0808X
NV21868163WC1500X, 163WC1600X, 163WE0003X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No171400000XOther Service ProvidersHealth & Wellness Coach
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WE0003XNursing Service ProvidersRegistered NurseEmergency