Basic Information
| Provider Information | |||||||||
| NPI: | 1831709740 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YUKEE | ||||||||
| FirstName: | MARIZEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4180 S. RAINBOW. STE. 810 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023833626 | ||||||||
| FaxNumber: | 7022278487 | ||||||||
| Practice Location | |||||||||
| Address1: | 4180 S. RAINBOW. STE. 810 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023833626 | ||||||||
| FaxNumber: | 7022278487 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2020 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 832355 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.