Provider Demographics
NPI:1912743956
Name:MONTES, LETICIA ANGELICA (APRN)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:ANGELICA
Last Name:MONTES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 OPALITE DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-7128
Mailing Address - Country:US
Mailing Address - Phone:775-220-5314
Mailing Address - Fax:
Practice Address - Street 1:1649 LUCERNE ST STE A
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4361
Practice Address - Country:US
Practice Address - Phone:775-782-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV821216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily