Provider Demographics
NPI:1760556534
Name:ESTIPONA, CATHERINE DIAZ (MSN APN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DIAZ
Last Name:ESTIPONA
Suffix:
Gender:F
Credentials:MSN APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5975 S LOS ALTOS PKWY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7699
Mailing Address - Country:US
Mailing Address - Phone:775-204-4000
Mailing Address - Fax:775-204-4001
Practice Address - Street 1:6275 SHARLANDS AVE STE B15-18
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-3734
Practice Address - Country:US
Practice Address - Phone:775-204-4000
Practice Address - Fax:775-204-4001
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000595363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP15128Medicare UPIN