Provider Demographics
NPI:1376421412
Name:AVILA, LILIANA (RN)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:AVILA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LILIANA
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:327 BURGOS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-4718
Mailing Address - Country:US
Mailing Address - Phone:702-624-2412
Mailing Address - Fax:
Practice Address - Street 1:327 BURGOS AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-4718
Practice Address - Country:US
Practice Address - Phone:702-624-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV882311251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health