Provider Demographics
NPI:1801057377
Name:N. RAO YERRAMSETTI
Entity type:Organization
Organization Name:N. RAO YERRAMSETTI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:NABONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-362-4567
Mailing Address - Street 1:2320 PASEO DEL PRADO # B-201B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4358
Mailing Address - Country:US
Mailing Address - Phone:702-362-4567
Mailing Address - Fax:702-362-4445
Practice Address - Street 1:2320 PASEO DEL PRADO # B-201B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4358
Practice Address - Country:US
Practice Address - Phone:702-362-4567
Practice Address - Fax:702-362-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5782207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002946Medicaid
NVV37731Medicare PIN