Active NPI
Tabitha Delacruz Agnir, NP
- Nurse Practitioner
- Las Vegas, NV
National Provider Identifier
1043869902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 821531
- Practice address
- 3901 Melbourne Way
Las Vegas, NV 89115-8141 - Phone
- (702) 557-9344
- NPI assigned
- Sep 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 821531 | NV | MD | Nurse Practitioner |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 821531 | NV | Primary |
Addresses
Primary practice location
3901 Melbourne Way
Las Vegas, NV 89115-8141
Mailing address
3901 Melbourne Way
Las Vegas, NV 89115-8141
Phone (702) 557-9344
NPI Registry JSON
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1043869902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 MELBOURNE WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891158141",
"telephone_number": "702-557-9344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 MELBOURNE WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891158141",
"telephone_number": "702-557-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGNIR",
"first_name": "TABITHA",
"middle_name": "DELACRUZ",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-04",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NV",
"license": "821531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.