Provider Demographics
NPI:1790663680
Name:ESTRADA, ROZELLE TUTO
Entity type:Individual
Prefix:
First Name:ROZELLE
Middle Name:TUTO
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 MOUNTAIN VISTA ST APT 158
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4679
Mailing Address - Country:US
Mailing Address - Phone:702-741-5863
Mailing Address - Fax:
Practice Address - Street 1:3850 MOUNTAIN VISTA ST APT 158
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4679
Practice Address - Country:US
Practice Address - Phone:702-741-5863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV892638163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health