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Individual

MS. BEVERLY BATALLA THIELKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
12300 SANDY PEAK AVE, LAS VEGAS, NV 89138-1116
(702) 606-2072
Mailing address
3459 SAINT ROSE PKWY STE 120-481, HENDERSON, NV 89052-4601
(702) 781-4800
(702) 664-6755

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
837645
NV
363LA2100X
Acute Care Nurse Practitioner
Primary
837645
NV
363LF0000X
Family Nurse Practitioner
837645
NV

Other

Enumeration date
02/01/2021
Last updated
10/22/2024
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