Individual
HEATHER TAMBURRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
911 N BUFFALO DR UNIT 113, LAS VEGAS, NV 89128-0380
(702) 960-4441
Mailing address
911 N BUFFALO DR, UNIT 113, LAS VEGAS, NV 89128-0380
(586) 229-7812
(231) 241-1109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
53283
CA
363A00000X
Physician Assistant
5601004975
MI
363A00000X
Physician Assistant
Primary
PA1390
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386764116
NPI
—
01
—
5601004975
MICHIGAN LARA
MI
01
—
CS20630
NV PHARMACY
NV
01
—
GW483Z
MEDICARE
NV
01
—
PA1390
NSBME
NV
Enumeration date
03/29/2007
Last updated
03/07/2023
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