Provider Demographics
NPI:1265081848
Name:LINA, ROSELLE ABLOG (APRN-CNP)
Entity type:Individual
Prefix:
First Name:ROSELLE
Middle Name:ABLOG
Last Name:LINA
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 1:6330 S PECOS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-6216
Mailing Address - Country:US
Mailing Address - Phone:702-433-1282
Mailing Address - Fax:
Practice Address - Street 1:3430 E FLAMINGO RD STE 311
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5067
Practice Address - Country:US
Practice Address - Phone:725-712-5792
Practice Address - Fax:702-433-8739
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVF06191111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily