Individual
TIANA DALERECA HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3450 W CHEYENNE AVE, STE 200, NORTH LAS VEGAS, NV 89032-8223
(314) 406-9081
(702) 789-0717
Mailing address
3450 W CHEYENNE AVE, STE 200, NORTH LAS VEGAS, NV 89032-8223
(314) 406-9081
(702) 789-0717
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2010027053
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN002430
NV
Other
Enumeration date
08/31/2010
Last updated
03/22/2019
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