Provider Demographics
NPI:1275261778
Name:CORTEZ, YSSEL TARRA (RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:YSSEL
Middle Name:TARRA
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 BARNTUCKET AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-4727
Mailing Address - Country:US
Mailing Address - Phone:702-688-9983
Mailing Address - Fax:
Practice Address - Street 1:777 N RAINBOW BLVD STE 350
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1188
Practice Address - Country:US
Practice Address - Phone:702-688-9983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA788938163W00000X
NVRN67765163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse