Provider Demographics
NPI:1023085982
Name:BLANCO-CUEVAS, NERI MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:NERI
Middle Name:MARIA
Last Name:BLANCO-CUEVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4441 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7826
Mailing Address - Country:US
Mailing Address - Phone:702-240-6374
Mailing Address - Fax:702-453-6374
Practice Address - Street 1:4441 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7826
Practice Address - Country:US
Practice Address - Phone:702-240-6374
Practice Address - Fax:702-453-6374
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10819208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
56-2546736OtherIRS TAX ID NUMBER