Provider Demographics
NPI:1104279249
Name:CASTRO-ROSENBERG, MARCIA (APRN)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:CASTRO-ROSENBERG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 DAYSPRING ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7819
Mailing Address - Country:US
Mailing Address - Phone:702-449-1010
Mailing Address - Fax:
Practice Address - Street 1:7906 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1990
Practice Address - Country:US
Practice Address - Phone:702-406-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002265363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health