Provider Demographics
NPI:1205448941
Name:BITUIN, CLEEANNE JUSTIN (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:CLEEANNE JUSTIN
Middle Name:
Last Name:BITUIN
Suffix:
Gender:M
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 S RAINBOW BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0855
Mailing Address - Country:US
Mailing Address - Phone:702-996-7877
Mailing Address - Fax:702-996-7807
Practice Address - Street 1:1811 S RAINBOW BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0855
Practice Address - Country:US
Practice Address - Phone:702-996-7877
Practice Address - Fax:702-996-7807
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN78172163WG0000X
NV833932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice