Provider Demographics
NPI:1447606835
Name:GARCIA, NYMPHA CABATU
Entity Type:Individual
Prefix:MISS
First Name:NYMPHA
Middle Name:CABATU
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NYMPHA
Other - Middle Name:CABATU
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2310 PASEO DEL PRADO
Mailing Address - Street 2:A203
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4357
Mailing Address - Country:US
Mailing Address - Phone:702-910-2333
Mailing Address - Fax:702-910-4473
Practice Address - Street 1:2310 PASEO DEL PRADO
Practice Address - Street 2:A203
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4357
Practice Address - Country:US
Practice Address - Phone:702-910-2333
Practice Address - Fax:702-910-4473
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20161219404163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV81-2497187OtherLIBERTY CREEK HOSPICE, LLC