Provider Demographics
NPI:1386281780
Name:STENROOS, LOURDES
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:STENROOS
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 1:4079 N RANCHO DR STE 195
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3465
Mailing Address - Country:US
Mailing Address - Phone:702-214-7928
Mailing Address - Fax:
Practice Address - Street 1:4079 N RANCHO DR STE 195
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3465
Practice Address - Country:US
Practice Address - Phone:702-214-7928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide