Provider Demographics
NPI:1902550296
Name:DEL ROSARIO, GUS ERIK (FNP)
Entity type:Individual
Prefix:
First Name:GUS ERIK
Middle Name:
Last Name:DEL ROSARIO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5980 WELLINGTON PEAK RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1498
Mailing Address - Country:US
Mailing Address - Phone:702-708-4096
Mailing Address - Fax:
Practice Address - Street 1:5980 WELLINGTON PEAK RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1498
Practice Address - Country:US
Practice Address - Phone:702-708-4096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV850851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily