Provider Demographics
NPI:1750959086
Name:QUIBA, WILLIAM V (APRN)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:V
Last Name:QUIBA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6720 N HUALAPAI WAY STE 145
Mailing Address - Street 2:BOX 12
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5120 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-1237
Practice Address - Country:US
Practice Address - Phone:702-720-4624
Practice Address - Fax:725-224-0909
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVAPRN839430363L00000X
NV839430363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPRN839430OtherMEDICAL LICENSE