Provider Demographics
NPI:1366033342
Name:DEL ROSARIO, MARY GRACE ALMIRANTE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARY GRACE
Middle Name:ALMIRANTE
Last Name:DEL ROSARIO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 SNOW GOOSE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9275
Mailing Address - Country:US
Mailing Address - Phone:702-355-9024
Mailing Address - Fax:
Practice Address - Street 1:5973 ATLANTIS DREAM AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-6978
Practice Address - Country:US
Practice Address - Phone:702-355-9024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPENDING363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health