Provider Demographics
NPI:1831709740
Name:YUKEE, MARIZEL
Entity type:Individual
Prefix:
First Name:MARIZEL
Middle Name:
Last Name:YUKEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 S. RAINBOW. STE. 810
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103
Mailing Address - Country:US
Mailing Address - Phone:702-383-3626
Mailing Address - Fax:702-227-8487
Practice Address - Street 1:4180 S. RAINBOW. STE. 810
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103
Practice Address - Country:US
Practice Address - Phone:702-383-3626
Practice Address - Fax:702-227-8487
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV832355363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care