Individual
MARILIZA CONSUL ILAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1321 S RAINBOW BLVD STE 101, LAS VEGAS, NV 89146-9047
(562) 215-9642
(702) 476-2975
Mailing address
10001 SUMMER OAK LN UNIT 102, LAS VEGAS, NV 89134-2624
(562) 215-9642
(702) 476-2975
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95001771
CA
Other
Enumeration date
01/13/2015
Last updated
03/12/2020
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