Provider Demographics
NPI:1558770289
Name:CHUA, EDNA GALINATO (APRN)
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:GALINATO
Last Name:CHUA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 SPRING MOUNTAIN RD
Mailing Address - Street 2:STE 112
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8724
Mailing Address - Country:US
Mailing Address - Phone:702-362-6373
Mailing Address - Fax:702-362-6420
Practice Address - Street 1:5300 SPRING MOUNTAIN RD
Practice Address - Street 2:STE 112
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8718
Practice Address - Country:US
Practice Address - Phone:702-362-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001465363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care