Provider Demographics
NPI:1619675725
Name:BLUEMEL, ELIZABETH CLAIRE (APRN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:BLUEMEL
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 1:1299 BERTHA HOWE AVE
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-7500
Mailing Address - Country:US
Mailing Address - Phone:702-346-8040
Mailing Address - Fax:702-346-4389
Practice Address - Street 1:1299 BERTHA HOWE AVE
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-7500
Practice Address - Country:US
Practice Address - Phone:702-346-8040
Practice Address - Fax:702-346-4389
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV862356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily