Roseline Agbetorwoka

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

818290 Issued in NV

Practice address

3920 W Charleston Blvd Ste O
Las Vegas, NV 89102-1633

Phone

(702) 478-5541

NPI assigned

Aug 16, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1043866833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 W CHARLESTON BLVD STE O",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021633",
            "telephone_number": "702-478-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 W CHARLESTON BLVD STE O",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021633",
            "telephone_number": "702-478-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBETORWOKA",
        "first_name": "ROSELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "818290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338661",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keonat@vegasbhs.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "3920 W Charleston Blvd Ste O",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891021633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jayson Paulo Alberto Agaton, N.P.
• Agave Specialty Care, LLC
• Bernadette Agbalog
• Miguel Angeles Agbayani
• Monamarie Rasquero Agbayani, BC-HIS
• Camille Agbuya
• Maria Agbuya
• Alouisa Gay Sahagun Agcaoili, APRN
• Carol Agcaoili
• Girlie S Agcaoili

• Registered Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Registered Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.