Provider Demographics
NPI:1417573148
Name:CRESCENT HEALTH LLC
Entity Type:Organization
Organization Name:CRESCENT HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:702-608-3574
Mailing Address - Street 1:6480 CREST ESTATES ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3253
Mailing Address - Country:US
Mailing Address - Phone:702-528-2195
Mailing Address - Fax:702-778-8026
Practice Address - Street 1:6480 CREST ESTATES ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-3253
Practice Address - Country:US
Practice Address - Phone:702-528-2195
Practice Address - Fax:702-778-8026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty