Provider Demographics
NPI:1053974832
Name:DELA PAZ, MARIAN CHRISTMAS BONUS (APRN)
Entity type:Individual
Prefix:
First Name:MARIAN CHRISTMAS
Middle Name:BONUS
Last Name:DELA PAZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 CANDLE LAKE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-1603
Mailing Address - Country:US
Mailing Address - Phone:702-444-7744
Mailing Address - Fax:
Practice Address - Street 1:3036 CANDLE LAKE CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1603
Practice Address - Country:US
Practice Address - Phone:702-444-7744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV819222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily