Provider Demographics
NPI:1558841965
Name:ALBANA, ELBETH ANTIPORTA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ELBETH
Middle Name:ANTIPORTA
Last Name:ALBANA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:ELBETH
Other - Middle Name:ANTIPORTA
Other - Last Name:ALBANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6479 W CAMERO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-7214
Mailing Address - Country:US
Mailing Address - Phone:702-301-4256
Mailing Address - Fax:
Practice Address - Street 1:1321 S RAINBOW BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9047
Practice Address - Country:US
Practice Address - Phone:702-476-2287
Practice Address - Fax:702-476-2035
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV812753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily