Provider Demographics
NPI:1194077867
Name:SOMES, AUDRA DOROTHY (RN MSN)
Entity type:Individual
Prefix:MRS
First Name:AUDRA
Middle Name:DOROTHY
Last Name:SOMES
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 COPPER RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2938
Mailing Address - Country:US
Mailing Address - Phone:717-614-3152
Mailing Address - Fax:
Practice Address - Street 1:5120 COPPER RIVER AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130
Practice Address - Country:US
Practice Address - Phone:717-614-3152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN28949163WE0003X
CTE57846163WE0003X
PARN588043163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency