Provider Demographics
NPI:1174498901
Name:TALABUCON, TRICIA ANNE VERGARA (RN)
Entity type:Individual
Prefix:
First Name:TRICIA ANNE
Middle Name:VERGARA
Last Name:TALABUCON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TRICIA ANNE
Other - Middle Name:PALOMA
Other - Last Name:VERGARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN MSN
Mailing Address - Street 1:403 LARKSONG AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-4533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:403 LARKSONG AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-4533
Practice Address - Country:US
Practice Address - Phone:412-218-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV847946163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty