Provider Demographics
NPI:1932897287
Name:BONTILAO, DELYN JESSICA (LPN/LVN)
Entity Type:Individual
Prefix:
First Name:DELYN JESSICA
Middle Name:
Last Name:BONTILAO
Suffix:
Gender:F
Credentials:LPN/LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7297 LINARIA RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3231
Mailing Address - Country:US
Mailing Address - Phone:915-996-5740
Mailing Address - Fax:
Practice Address - Street 1:7297 LINARIA RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3231
Practice Address - Country:US
Practice Address - Phone:915-996-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074631164W00000X
CA717736164X00000X
NV862980164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse