Provider Demographics
NPI:1518150531
Name:AFRICA, MYRNA ANGELES (APN)
Entity Type:Individual
Prefix:MRS
First Name:MYRNA
Middle Name:ANGELES
Last Name:AFRICA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8077 MESQUITE RANCH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-4017
Mailing Address - Country:US
Mailing Address - Phone:702-222-1977
Mailing Address - Fax:702-222-1977
Practice Address - Street 1:8077 MESQUITE RANCH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4017
Practice Address - Country:US
Practice Address - Phone:702-222-1977
Practice Address - Fax:702-222-1977
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVTAPN700371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily