Individual
MELCHOR SAN PEDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-C
Contact information
Practice address
2250 E FLAMINGO RD, LAS VEGAS, NV 89119-5170
(702) 703-4340
(877) 951-6896
Mailing address
2250 E FLAMINGO RD, LAS VEGAS, NV 89119-5170
(702) 703-4340
(877) 951-6896
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN43698
NV
363LF0000X
Family Nurse Practitioner
Primary
829103
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
829103
LICENSE
NV
01
—
RN43698
LICENSE
NV
Enumeration date
02/07/2020
Last updated
03/12/2020
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