Basic Information
| Provider Information | |||||||||
| NPI: | 1245854363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | VANESSA LOREN | ||||||||
| MiddleName: | LACSAMANA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN MSN FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 E SILVERADO RANCH BLVD STE 170 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891837518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022406482 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7455 W WASHINGTON AVE STE 420 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891284352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022406482 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2020 | ||||||||
| LastUpdateDate: | 09/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 827713 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 827713 | NV | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.