Provider Demographics
NPI:1255098695
Name:ELARIO, MARIA TERESA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:ELARIO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:TERESA
Other - Last Name:DE CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6550 S PECOS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2829
Mailing Address - Country:US
Mailing Address - Phone:702-800-2862
Mailing Address - Fax:
Practice Address - Street 1:6550 S PECOS RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2829
Practice Address - Country:US
Practice Address - Phone:702-800-2862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV845194363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily