Provider Demographics
NPI:1710690243
Name:CUDIAMAT, ERLENE G (APRN)
Entity Type:Individual
Prefix:
First Name:ERLENE
Middle Name:G
Last Name:CUDIAMAT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 W SAHARA AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-6001
Mailing Address - Country:US
Mailing Address - Phone:725-292-6829
Mailing Address - Fax:636-212-9019
Practice Address - Street 1:3227 E WARM SPRINGS RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3180
Practice Address - Country:US
Practice Address - Phone:702-292-6829
Practice Address - Fax:636-212-9019
Is Sole Proprietor?:No
Enumeration Date:2022-12-29
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV861111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily