Individual
RENNETTE TIAMSON BULATAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 877-5119
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(760) 708-5463
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
815814
NV
363LG0600X
Gerontology Nurse Practitioner
Primary
815814
NV
Other
Enumeration date
06/15/2022
Last updated
04/09/2026
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