Individual
MARY ELIZABETH WARDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN,FNP-C
Contact information
Practice address
2650 N TENAYA WAY STE 302, LAS VEGAS, NV 89128-1112
(702) 240-0088
(702) 240-3049
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN002872
NV
363LF0000X
Family Nurse Practitioner
Primary
APRN002872
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235624388
—
NV
01
—
APRN002872
STATE LICENSE
NV
Enumeration date
06/29/2018
Last updated
10/20/2022
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