IDA PRAILE SORONGON NURSE PRACTITIONER NPI 1700225844

NPI Information

NPI: 1700225844
Provider Name: IDA PRAILE SORONGON, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
3343 S EASTERM AVENUE
LAS VEGAS, NV
ZIP 89169
Phone: (702) 731-0909
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Ida Praile Sorongon, NURSE PRACTITIONER is a family nurse practitioner in Las Vegas, NV. Ida Praile Sorongon, NURSE PRACTITIONER NPI is 1700225844. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3343 S EASTERM AVENUE
LAS VEGAS, NV
ZIP 89169
Phone: (702) 731-0909
Fax: (702) 731-1020

The NPI 1700225844 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2013 and was last updated on 10/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	APN001519	NEVADA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1700225844	MEDICAID	NEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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