Provider Demographics
NPI:1598009219
Name:QUIAMZON-SARREAL, ELVIRA G (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ELVIRA
Middle Name:G
Last Name:QUIAMZON-SARREAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:ELVIRA
Other - Middle Name:G
Other - Last Name:QUIAMZON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:8818 DRAMATIC GOLD AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-6561
Mailing Address - Country:US
Mailing Address - Phone:702-461-8113
Mailing Address - Fax:
Practice Address - Street 1:2810 W CHARLESTON BLVD
Practice Address - Street 2:STE 53
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1921
Practice Address - Country:US
Practice Address - Phone:702-877-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily