Provider Demographics
NPI:1154948123
Name:MAPULA, KAROL LIZETH
Entity type:Individual
Prefix:
First Name:KAROL
Middle Name:LIZETH
Last Name:MAPULA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10369 BABY BUD ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4294
Mailing Address - Country:US
Mailing Address - Phone:702-619-2113
Mailing Address - Fax:
Practice Address - Street 1:1020 S BOULDER HWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-8533
Practice Address - Country:US
Practice Address - Phone:702-791-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered