Basic Information
| Provider Information | |||||||||
| NPI: | 1720638422 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WABSIS | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | DENISE | ||||||||
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| Credential: | APRN FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1470 E CALVADA BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PAHRUMP | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890483906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752108333 | ||||||||
| FaxNumber: | 7753469158 | ||||||||
| Practice Location | |||||||||
| Address1: | 1470 E CALVADA BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PAHRUMP | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890483906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752108333 | ||||||||
| FaxNumber: | 7753469158 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2019 | ||||||||
| LastUpdateDate: | 03/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 822995 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.