Provider Demographics
NPI:1386322055
Name:PELUAGA, MICHELLE N (CP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:N
Last Name:PELUAGA
Suffix:
Gender:F
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 W CHEYENNE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8207
Mailing Address - Country:US
Mailing Address - Phone:702-233-5500
Mailing Address - Fax:
Practice Address - Street 1:3435 W CHEYENNE AVE STE 102
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8207
Practice Address - Country:US
Practice Address - Phone:702-233-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP003913224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist