Individual
KELLY BUCALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
911 N BUFFALO DR UNIT 213, LAS VEGAS, NV 89128-0381
(702) 405-8088
Mailing address
911 N BUFFALO DR UNIT 213, LAS VEGAS, NV 89128-0381
(702) 405-8088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
820127
NV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
820127
NV
Other
Enumeration date
06/28/2019
Last updated
02/25/2020
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