| Infectious Diseases Of Nevada Llc | |
|
3483 S Eastern Ave Las Vegas NV 89169-3314 | |
| (702) 487-7055 | |
| Not Available |
| Full Name | Infectious Diseases Of Nevada Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3483 S Eastern Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Cara Fanning (OWNER) |
| Authorized Official Contact | 7023287594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Diseases Of Nevada Llc 7021 Saddle Back Peak St Las Vegas NV 89166-7127 Ph: (702) 328-7594 | Infectious Diseases Of Nevada Llc 3483 S Eastern Ave Las Vegas NV 89169-3314 Ph: (702) 487-7055 |
| NPI Number | 1932648847 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 01/07/2020 |
| Medicare PECOS PAC ID | 5496032617 |
|---|---|
| Medicare Enrollment ID | O20170425003126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932648847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (Nevada) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (Nevada) | Secondary |
| Provider Name | Cara F Fanning |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841288107 PECOS PAC ID: 4587611850 Enrollment ID: I20050407001251 |
| Provider Name | Jiji Ochoa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912390196 PECOS PAC ID: 2668786237 Enrollment ID: I20150728003725 |
| Provider Name | Shawnna Maria Fitzwater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962715946 PECOS PAC ID: 4385947720 Enrollment ID: I20171130001320 |
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