Provider Demographics
NPI:1356930796
Name:TAITANO, ASHLEY RENE (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENE
Last Name:TAITANO
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 1:330 S CASINO CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6102
Mailing Address - Country:US
Mailing Address - Phone:702-671-5690
Mailing Address - Fax:702-366-0576
Practice Address - Street 1:330 S CASINO CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6102
Practice Address - Country:US
Practice Address - Phone:702-671-5690
Practice Address - Fax:702-366-0576
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV829623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily