Provider Demographics
NPI:1821961699
Name:MENDOZA, KATHERIN BELEN (RN)
Entity type:Individual
Prefix:
First Name:KATHERIN
Middle Name:BELEN
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 STILLWATER BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-7921
Mailing Address - Country:US
Mailing Address - Phone:702-463-1011
Mailing Address - Fax:702-268-8001
Practice Address - Street 1:1411 STILLWATER BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-7921
Practice Address - Country:US
Practice Address - Phone:702-463-1011
Practice Address - Fax:702-268-8001
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV890795251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health