Provider Demographics
NPI:1962225516
Name:INES, IRENE NANAO (APRN-CNP)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:NANAO
Last Name:INES
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 MOSSY VALE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4583
Mailing Address - Country:US
Mailing Address - Phone:586-565-1811
Mailing Address - Fax:
Practice Address - Street 1:3201 S MARYLAND PKWY STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2423
Practice Address - Country:US
Practice Address - Phone:702-910-6857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV821332363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care