Individual
MEREDITH NETTLES D'AGOSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP, CPNP
Contact information
Practice address
500 N RAINBOW BLVD STE 300-345, LAS VEGAS, NV 89107-1082
(833) 246-8353
(844) 750-6902
Mailing address
500 N RAINBOW BLVD STE 300-345, LAS VEGAS, NV 89107-1082
(833) 246-8353
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
3584
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3584
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
816203
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3584-APRN
MEDICAL LICENSE
SC
01
—
816203
NV APRN LICENSE
NV
05
—
NP1367
—
SC
Enumeration date
06/09/2008
Last updated
09/08/2020
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