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Individual

BLANCHE LENORA BRAGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
6865 W TROPICANA, LAS VEGAS, NV 89103
(866) 825-3227
(866) 397-7399
Mailing address
4165 30TH AVE S SUITE 101, FARGO, ND 58104-8419
(866) 825-3227
(866) 397-7399

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APN000739
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100500634
NV
05
100500635
NV
05
1851361943
NV
Enumeration date
01/23/2006
Last updated
05/09/2008
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