Individual provider · Type 1 NPI
Rennette Tiamson Bulatao, NURSE PRACTITIONER
Gerontology Nurse Practitioner · Las Vegas, NV
NPI number
1285364877
Active
Practice location
4475 S Eastern Ave
Las Vegas, NV 89119-7826
Mailing address
PO Box 35380
Las Vegas, NV 89133-5380
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 815814 (NV) |
| Family Nurse Practitioner | 363LF0000X | 815814 (NV) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1285364877
Rennette Tiamson Bulatao, NURSE PRACTITIONER's National Provider Identifier is 1285364877, issued on Jun 15, 2022. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Las Vegas, NV. The record was last updated on Apr 9, 2026.