Provider Demographics
NPI:1386205052
Name:DIZON, RHIA JOY LUMANOG (NP)
Entity Type:Individual
Prefix:
First Name:RHIA JOY
Middle Name:LUMANOG
Last Name:DIZON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 TIDELANDS PARK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-7132
Mailing Address - Country:US
Mailing Address - Phone:702-426-1049
Mailing Address - Fax:
Practice Address - Street 1:7003 TIDELANDS PARK CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-7132
Practice Address - Country:US
Practice Address - Phone:702-426-1049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV821568363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care