Individual
BERNADETTE PAYUMO ABREGUNDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5771 S FORT APACHE RD STE 100, LAS VEGAS, NV 89148-5626
(702) 951-3400
(702) 951-3403
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP126948
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
844939
NV
363LG0600X
Gerontology Nurse Practitioner
AP126948
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP126948
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0346209502
—
TX
05
—
1861899841
—
NV
05
—
3462095-05
—
TX
01
—
412738ZSJC
MEDICARE
TX
01
—
844939
STATE LICENSE
NV
01
—
P01666642
RR MEDICARE
TX
Enumeration date
11/19/2014
Last updated
06/24/2024
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