Provider Demographics
NPI:1336486182
Name:LABONTE, EMILY D (FNP- BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:D
Last Name:LABONTE
Suffix:
Gender:F
Credentials:FNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:5230 BOULDER HWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-6076
Practice Address - Country:US
Practice Address - Phone:702-940-1560
Practice Address - Fax:702-940-1561
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17331363LF0000X
NVAPRN002058363LF0000X
NVRN85784163W00000X
TN166007163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPRN002058OtherSTATE LICENSE
NV1336486182Medicaid