Provider Demographics
NPI:1538503677
Name:PANGANIBAN, ROWENA D (NP-C)
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:D
Last Name:PANGANIBAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ROWENA
Other - Middle Name:
Other - Last Name:PANGANIBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN FNP -C
Mailing Address - Street 1:9555 S EASTERN AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-8008
Mailing Address - Country:US
Mailing Address - Phone:702-447-0333
Mailing Address - Fax:702-447-0340
Practice Address - Street 1:9555 S EASTERN AVE STE 260
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-8008
Practice Address - Country:US
Practice Address - Phone:702-447-0333
Practice Address - Fax:702-447-0340
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily