Provider Demographics
NPI:1497432785
Name:PANGILINAN, PRINCESS (NP)
Entity Type:Individual
Prefix:
First Name:PRINCESS
Middle Name:
Last Name:PANGILINAN
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 1:8317 SPANISH CREEK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-4688
Mailing Address - Country:US
Mailing Address - Phone:818-943-9059
Mailing Address - Fax:
Practice Address - Street 1:801 S RANCHO DR STE B1B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3871
Practice Address - Country:US
Practice Address - Phone:702-490-2398
Practice Address - Fax:702-912-2273
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV866562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily