Provider Demographics
NPI:1982921037
Name:DEMAVIVAS, MARIA TERESA (APN)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:TERESA
Last Name:DEMAVIVAS
Suffix:
Gender:F
Credentials:APN
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Other - First Name:
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Mailing Address - Street 1:3100 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1900
Mailing Address - Country:US
Mailing Address - Phone:702-877-9511
Mailing Address - Fax:702-877-6711
Practice Address - Street 1:3100 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1900
Practice Address - Country:US
Practice Address - Phone:702-877-9511
Practice Address - Fax:702-877-6711
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVAPN001170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily