Provider Demographics
NPI:1164177309
Name:LOPREIATO, MIA (CNP)
Entity Type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:LOPREIATO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8124 DIAMOND GORGE RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-8236
Mailing Address - Country:US
Mailing Address - Phone:702-301-4420
Mailing Address - Fax:
Practice Address - Street 1:3900 W CHARLESTON BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1629
Practice Address - Country:US
Practice Address - Phone:702-362-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN847936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily