Individual
ROBERT BUSTAMANTE BAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4040 S EASTERN AVE STE 300, LAS VEGAS, NV 89119-0854
(949) 438-9086
Mailing address
9164 NOVEL CT, LAS VEGAS, NV 89149-3087
(949) 438-9086
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
862361
NV
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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