Provider Demographics
NPI:1275630139
Name:DIPIETRO, JOYCE MICHELE (APRN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:MICHELE
Last Name:DIPIETRO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:MICHELE
Other - Last Name:LENTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7220 S CIMARRON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2157
Mailing Address - Country:US
Mailing Address - Phone:702-384-1160
Mailing Address - Fax:702-835-0676
Practice Address - Street 1:7220 S CIMARRON RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:702-384-1160
Practice Address - Fax:702-835-0676
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN00352163W00000X
NVRN28058163W00000X
NVAPRN00352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002402084Medicaid
NVS54933Medicare UPIN