Provider Demographics
NPI:1457763849
Name:MAGTOTO, MARIA CARMELA (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CARMELA
Last Name:MAGTOTO
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 1:10255 BRIGHT HARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-2846
Mailing Address - Country:US
Mailing Address - Phone:702-544-1442
Mailing Address - Fax:
Practice Address - Street 1:2770 S MARYLAND PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1564
Practice Address - Country:US
Practice Address - Phone:702-737-1771
Practice Address - Fax:702-737-7871
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily