Provider Demographics
NPI:1700190055
Name:RECHTZIGEL, DEANNA LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNN
Last Name:RECHTZIGEL
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 1:7455 W WASHINGTON AVE
Mailing Address - Street 2:#160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4337
Mailing Address - Country:US
Mailing Address - Phone:702-878-0393
Mailing Address - Fax:702-258-5564
Practice Address - Street 1:7455 W WASHINGTON AVE
Practice Address - Street 2:#160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4337
Practice Address - Country:US
Practice Address - Phone:702-878-0393
Practice Address - Fax:702-258-5564
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVTAPN700604163W00000X
NVAPRN001234363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPRN001234OtherLICENSE
NVEG902ZMedicare PIN