Individual
MR. JOHNNY MIRADOR CHUA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
3150 N TENAYA WAY STE 260, LAS VEGAS, NV 89128-0459
(702) 962-5920
Mailing address
3150 N TENAYA WAY STE 260, LAS VEGAS, NV 89128-0459
(702) 962-5920
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
817423
NV
363LA2100X
Acute Care Nurse Practitioner
817423
NV
Other
Enumeration date
01/14/2019
Last updated
11/01/2021
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