Provider Demographics
NPI:1285865774
Name:CERDAN, NOELLE SERRANO (PNP)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:SERRANO
Last Name:CERDAN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4570 S EASTERN AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6183
Mailing Address - Country:US
Mailing Address - Phone:702-733-6033
Mailing Address - Fax:702-892-9567
Practice Address - Street 1:4570 S EASTERN AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6183
Practice Address - Country:US
Practice Address - Phone:702-733-6033
Practice Address - Fax:702-892-9567
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN51018363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics