Provider Demographics
NPI:1437980588
Name:DE LA CRUZ-ESTES, MONICA MARY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:MARY
Last Name:DE LA CRUZ-ESTES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:5785 N DURANGO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3958
Mailing Address - Country:US
Mailing Address - Phone:702-582-4129
Mailing Address - Fax:
Practice Address - Street 1:8751 W CHARLESTON BLVD STE 190
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5483
Practice Address - Country:US
Practice Address - Phone:702-582-4129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVF07241123363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner