Provider Demographics
NPI:1700122900
Name:PIERRO-FOSTER, MARIA-ELENA (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIA-ELENA
Middle Name:
Last Name:PIERRO-FOSTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50605
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89016-0605
Mailing Address - Country:US
Mailing Address - Phone:702-740-5327
Mailing Address - Fax:702-740-5328
Practice Address - Street 1:7195 ADVANCED WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3691
Practice Address - Country:US
Practice Address - Phone:702-740-5327
Practice Address - Fax:702-740-5328
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1399363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100840Medicare UPIN