Individual provider · Type 1 NPI

Mario Oliver Tablante Godoy, APRN NP-C

Primary Care Nurse Practitioner · Las Vegas, NV

NPI number 1275822611 Active

Practice location

1706 W Bonanza Rd
Las Vegas, NV 89106-4704

Fax (702) 631-6864

Mailing address

8010 Bradley Rd
Las Vegas, NV 89131-2016

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000XAPRN001258 (NV)
Primary Care Nurse Practitioner Primary 363LP2300XAPRN001258 (NV)
Registered Nurse 163W00000XRN67477 (NV)

Primary Care Nurse Practitioner: Definition to come...

6 other providers at this address

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About NPI 1275822611

Mario Oliver Tablante Godoy, APRN NP-C's National Provider Identifier is 1275822611, issued on Apr 6, 2011. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Las Vegas, NV. The record was last updated on Feb 10, 2026.