Provider Demographics
NPI:1235668518
Name:GO, MERLE AMBRAY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MERLE
Middle Name:AMBRAY
Last Name:GO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 E FLAMINGO RD APT 224
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7443
Mailing Address - Country:US
Mailing Address - Phone:702-203-0385
Mailing Address - Fax:
Practice Address - Street 1:1055 E FLAMINGO RD
Practice Address - Street 2:APT 224
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-203-0385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN35632163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty