Individual
MRS. DORINA M TAVERNARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8551 W LAKE MEAD BLVD, LAS VEGAS, NV 89128-7642
(702) 666-8645
Mailing address
8551 W LAKE MEAD BLVD, LAS VEGAS, NV 89128-7642
(702) 666-8645
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
835857
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
NV
Enumeration date
03/12/2021
Last updated
05/31/2024
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